Review an Existing Claim

Benefits Review
Your Housing Benefit / Council Tax Reduction entitlement is being reviewed.

Please complete all the sections below, even if your circumstances have not changed since you last completed a Housing Benefit Review form.
Section 1 - Personal Details
1. Claim reference number*
2. Title:*
3. First name(s):*
4. Surname:*
5. What is your preferred method of contact?*
6. GROUPEMAIL
  1. Email address:
  2. Phone number (optional):
7. Group
  1. Phone number:
  2. Email address (optional):
8. Address
  1. Postcode*
    
    Address
Section 2 - Other People who live with you
1. Other people who live with you list the names of everybody else who lives in your household, including dependent children and any other adults. If no one else lives with you, please write “none”.
Section 3 - You, your partner’s and other members of your household’s income
1. Give details of all Income you receive (for all members of your household) and how often you receive them (e.g. weekly, four weekly, monthly etc.) Examples would include Universal Credit, Child Benefit, Working Tax Credit, Child Tax Credit, PIP, Carers Allowance, Job Seekers Allowance, Private/State Pension, Maintenance payments and Earnings etc.
  
  If you are self employed, please visit Change a Claim to complete a Change of Circumstances form.
Section 4 - You and/or your partner’s savings and capital
1. If your (and your partner’s joint) capital is less than £6,000 please write “capital below threshold” if your capital is over £6,000 please give details of all your bank accounts (including current accounts), building society accounts, Post Office accounts, investments, stocks, premium bonds, shares, National Savings Certificates, property or land you own etc.
Section 5 - About your rent
1. Only complete this section if you live in rented accommodation.
  (If you do not live in rented accommodation go on to the next section).
2. Landlord/Agent's name
3. How much is your rent?
4. Every
5. Does your rent include anything other than rent for the property, such as water or heating charges for example? If yes, tell us how much you pay and what it is for.
6. Anything other than rent
Section 6 - Anything else you need to tell us
1. Use this box to tell us anything else that has changed, or has not been covered in the previous sections. If you incur child care costs, please give details. If there are no other changes write “none”.
2. Anything else to tell us
Section 7 - Declaration
1. We will process personal information included in this form to enable us to assess your benefit entitlement. The Council processes this information legally in its performance of public task. Your information may be shared with other parties in connection with your claim. Please see for more information.
  I understand that:
  
  If I give information that is incorrect or incomplete, you may take action against me. This may include court action. You will use the information I have provided to process my claim for Housing Benefit and Council Tax Reduction. You may check some of the information with other sources within the council, rent offices and other councils.
  
  You may use any information I have provided in connection with this and any other claim for DWP benefits that I have made or may make. We may give some information to other organisations, if the law allows this.
  
  I know I must let the Council’s Benefits Section know about any changes in my circumstances which might affect my claim.
  
  I declare the information I have given on this form is correct and complete.
2. Please tick to confirm if you agree with the above statement: check declaration

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For Your Information

Review an Existing Claim

Benefits Review