Housing Benefit Review Form

First Name(s) *

Last Name *

Address *

Postcode

Landline number

Mobile Number *

Email address *

Please note we will correspond with you about your claim using this address. To protect your privacy please do not use an email that is not personal to you.

National Insurance Number

Date of birth *

Claim Reference Number *

Your claim reference number should be 9 digits and start with a 1.

Are you a full-time student? *

Housing Benefit Review Form

Your Details