Benefits - Request for reconsideration of Housing Benefit and/or Council Tax Benefit decision

Please complete all relevant boxes on the form. You can get help from an advice centre or a solicitor.

Please state the reasons for your request. This is important because we do not have to look at anything you do not mention.
When completed print the form, sign and return to the address given within one month of the date on the decision letter.
Make sure you have said on this form why you do not agree with the decision.
Take or send this form to us.