Contact Us
General Enquiries : 01702 215000
Alternatively, Visit our Website
Return to Site

Reconsideration form for benefits claim


If you disagree with the decision made on your claim you have the right to request that your claim is looked at again.

You will need to complete and submit this form within one month of the date of the decision letter stating why you consider the decision to be wrong and include any information you think may support your case.

The case will be looked at again and you will be informed by letter of the outcome.

 

Claimant Details

Address
The "Find Address" facility is only available for addresses within the Southend-on-Sea Borough. For addresses outside the Borough please complete the following fields manually.
 
 
 

Please supply any proof you feel will support your request for reconsideration. If we need to see more we will contact you.

 
 
I am completing this form: *
I am completing this form:
 
If you are completing this form on behalf of the claimant:

Your details

 

Declaration


I declare that the information I have given on this form is correct and complete. *
I declare that I have confirmed with the person claiming that the information I have given on this form is accurate. *
 
Date completed23 Mar 2017 

Thank you. We will be in touch shortly.

eForms by AchieveForms