Tandridge District Council Forms

Benefits change of circumstances notification form

Page 1

In order to deal with your change of circumstance as quickly as possible, please ensure you have provided us with as much detail as possible. It may also be necessary for us to see documentation relating to this change. We will telephone, email or write to you as necessary.

Your benefit claim number

This number can be found on any notification sent to you on the top right side of the document. It is the first 9 characters after Ref: (e.g. 50012345X)

Title

If 'Other' please state

First name

Surname

Address

Please enter your postcode in the box below, including the space, ie RH8 0BT, and click the 'Show Postcode Addresses' button and select your address.

Postcode

Address

E-mail address

If you provide your e-mail address and tick the box to opt in, we’ll keep you up to date with information about our services, as well as local news and events. We promise to only send information that’s relevant and you will always be able to unsubscribe.

Opt in

Telephone

Page 2

Please indicate the type of circumstance change you wish to inform us about

If other, please state

The date this change happened

Please give the details of the change here including the name of any persons to whom they apply

We may require further information about this change. We will contact you as necessary.

Name of person completing this form

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