If you do not agree with a decision we have made about your claim for Housing Benefit or Council Tax Support (or both), you can use this form to ask us to explain our decision or to ask us to look at our decision again. We must get this form within one month of the date of your decision letter.

You can use this form to:

  • ask us to look at the decision again
  • ask us to explain our decision
  • appeal against the decision.

All fields marked with * must be completed.

Part 1 - What do you want us to do?
Part 2 - Personal details
Two letters, then six numbers and then one letter.
Address details
Part 3 - About your claim
A nine digit number starting with an '8'.

If 'Yes' please fill their details below.

Part 4 - About landlords or third parties
Part 5 - The details - Use this space to say why you do not agree with our decision. Remember to provide original documents or information to support what you say.

You may upload up to three documents to support your appeal. Each document can be a maximum of 10 megabytes (10mb) in size. We accept the following document types:

  • Microsoft Office documents (Word, Excel, Powerpoint)
  • Ritchtext documents (.rtf)
  • Adobe PDF documents
  • Text (.txt)
  • Jpeg and PNG image files.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png bmp eps tif pict psd txt rtf html pdf doc docx ppt pptx xls xlsx xml avi mov mp3 ogg wav zip.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png bmp eps tif pict psd txt rtf html pdf doc docx ppt pptx xls xlsx xml avi mov mp3 ogg wav.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png bmp eps tif pict psd txt rtf html pdf doc docx ppt pptx xls xlsx xml avi mov mp3 ogg wav zip.
Part 6 - Promoting equality

Please help us to make sure that all groups in the community are claiming their full entitlement to benefit by filling in this part. It will not affect your claim in any way if you do not answer. You do not have to fill in this part, but it will help us if you do.

Your responses will be kept confidential and any information published will be made anonymous. No information that can identify you, your home or your household will be passed to any other organisations without asking you first.