Challenge a benefit decision 1Using the form2Declaration3About you4About the claimant5The decision you disagree with6The decision you disagree with (continued)7Supporting documents and other information If you disagree with our decision about your Housing Benefit or Council Tax Support, you can use this form to challenge it. Only certain people can challenge this decision. This is usually only the claimant but a landlord can if our decision is not to pay Housing Benefit to the landlord, or we ask the landlord to pay back any Housing Benefit we have overpaid. This form will ask you to provide If you are the claimant your details including National Insurance number which decision you would like to challenge and your reasons for doing so the date on the top of your decision letter any proof or information to support what you are telling us. If you are a landlord your name and contact details the full name and address of the claimant the Housing Benefit reference number (if known) which decision you would like to challenge and your reasons for doing so the date on the top of the decision letter any proof or evidence to support what you are telling us. Please have this information ready as pages time-out after one hour. Do not use your browser back button – if you need to go to a previous page click on the previous button at the bottom of each page. Privacy Statement Dover District Council is a Data Controller under GDPR. In submitting this form we will collect and process your personal data. For information about your rights and how the Council uses your data, please view our Corporate and relevant service privacy notice which can be found on our Privacy page. DeclarationAre you a claimant, filling in this form on behalf of a claimant or a landlord? I am a claimant and I’m filling in this form for myself I’m filling in this form on behalf of the claimant I am a landlord Declaration (claimant)Please check the box below to confirm that you have read, understand and agree to the following statements before completing this form: I confirm the details I will give are correct and that the documents I will upload as proof are original copies and have not been edited in any way. I understand that if I give information that is false this could lead to a penalty or legal proceedings being taken against me. I understand my data may be shared with other departments as permitted by law. Declaration (landlord)Please check the box below to confirm that you have read, understand and agree to the following statements before completing this form: I confirm the details I will give on this form are correct and true. I understand that if I give information that is false this could lead to a penalty or legal proceedings being taken against me. I understand my data may be shared with other departments as permitted by law. A landlord can only challenge decisions about who the benefit is paid to and who an overpayment is recovered from. If you disagree with anything else about the claim, the request for the reconsideration must be made by the claimant. You can support them to do this (providing you have their consent) by selecting the option “I’m filling in this form on behalf of the claimant”.Declaration (completing on behalf of someone else)Please check the box below to confirm that you have read, understand and agree to the following statements before completing this form: As far as possible, I will confirm with the person claiming that the answers I will give on this form are correct and that the documents I will upload as proof are original copies and have not been edited in any way. I understand that if I give information that is false this could lead to a penalty or legal proceedings being taken against me. I understand my data may be shared with other departments as permitted by law. Please note that we will send any correspondence about this request to the claimant. If you have signed authority to act on the claimant’s behalf, you can attach this to this form later and we will contact the claimant to check this.This field is hidden when viewing the formDeclaration(Required) I understand and accept the above declarationI am filling in this form on behalf of(Required)As they cannot fill in the form because(Required)Full name of the person completing this form(Required)Relationship to the person claiming(Required)Contact email address or phone number(Required)If we need to check any of the details given, we may need to contact you About you (the claimant)About you (the landlord)Title (for example Mr, Mrs, Ms, Miss)(Required)First name(Required)Last name(Required)Contact phone number(Required)We ask for your phone number so we can call you or send you important text messages (if we need to) about your claim.Please enter your email address(Required)We will use your email address to send the receipt of your form, including the form reference number. This may include personal data. We will also use your email address to contact you about your Council Tax account. Enter email address Confirm email address Would you like to receive your Council Tax bills by email?(Required)You can receive your Council Tax bills by email rather than post. We will send all future Council Tax bills to the email address you have given above. This service is only available to people who are named on the bill. If you change your email address you must let us know straight away. You can opt out of this at any time at dover.gov.uk/paperless Yes No Company name (if applicable)Housing Benefit or Council Tax Support reference number (if known)National Insurance number(Required)About your addressAddress(Required) Address line 1 Address line 2 Town or city Postcode About the claimantHousing Benefit reference numberFull name of the claimant(Required)About the claimant's addressClaimant's address(Required) Address line 1 Address line 2 Town or city Postcode The decision you disagree with – landlordWhat type of decision are you challenging?(Required) Who the Housing Benefit is being paid to Who an overpayment is being recovered from Who do you think Housing Benefit should be paid to and why?(Required)Why do you think the overpayment should be recovered from someone else?(Required)The decision you disagree withWhich decision do you disagree with?(Required) Housing Benefit only Housing Benefit and Council Tax Support Council Tax Support only (this includes Second Adult Rebate) Date of the decision you disagree with(Required)This is the date on the notification letter we have sent youDayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920If it has been over a month since the date of your decision letter, please tell us why you haven't contacted us sooner(Required) The decision you disagree with (continued)What type of decision are you challenging?(Required)Please select…Failure to provide information or proofBackdating refusalStart date or date of changeBenefit overpaymentIncome or capital (savings and investments) calculationTenancy type or rent details (Housing Benefit only)Other reasonThis field is hidden when viewing the formFailure to provide information or proofPlease tell us why you didn't provide all the proof and information we asked for within one month(Required)This field is hidden when viewing the formBackdating refusalPlease tell us why you didn't apply earlier(Required)Please note that not knowing that you could claim is not a valid reason for asking for your claim to be backdatedThis field is hidden when viewing the formStart date or date of changeWhy do you think the date is wrong?(Required)What date do you think we should be using?(Required)DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920This field is hidden when viewing the formBenefit overpaymentWhat do you disagree with?(Required)Please select…The amount of the overpaymentWho is paying back the overpaymentThe way we're collecting the overpayment or how much we're collectingWhy do you think the overpayment amount is wrong?(Required)Why do you think the overpayment should be recovered from someone else?(Required)Please see our Housing Benefit overpayments page for information about how we recover overpayments and to find out how you can pay. Arranging a different way of paying back your overpayment is not a challenge and you do not need to complete this form; please see the advice on our webpages instead. This field is hidden when viewing the formIncome or capital (savings and investments) calculationWhy do you think your income or capital (savings and investments) has been used incorrectly?(Required)What do you think we should have used?(Required)This field is hidden when viewing the formTenancy type or rent detailsWhy do you think your liability to pay rent or the amount of rent used in the calculation of your award is wrong?(Required)What do you think the decision should be?(Required)This field is hidden when viewing the formWhy you disagree with our decisionPlease tell us what you disagree with about the decision(Required)What do you think should be changed?(Required) Supporting documents and other informationIf you have any proof or evidence to support what you are telling us, please upload this. If you have no proof or evidence, please leave the page blank and click the next button to continue with the form. If you are sending proof later, please use the online form on our website at dover.gov.uk/proofPlease upload any proof or evidence to support what you are telling usIf you are uploading photographs of documents, please make sure you take a photo of every relevant page, that they are clear and that any words or figures can be easily read. Drop files here or Select files Accepted file types: txt, pdf, doc, docx, rtf, jpg, jpeg, tif, tiff, bmp, png, xls, xlsx, Max. file size: 3 MB, Max. files: 5. Please use this box to tell us any other informationIf you have no further information to give us, leave the box blank
