[Your address]
								[Your telephone number]
								[Your email address]
								[Date]

[Adress of the Council’s housing benefit department]

By [first class post / hand / email to: [insert email address]


Dear Sir/Madam

Re:	Request for backdating of housing benefit claim
	Housing Benefit Regulations 2006, SI No. 213, Reg 83(12)(b)
	Your ref: [Housing benefit reference number]

I write to ask that my claim for housing benefit is backdated to [date you think benefit should be paid from].

I was not able to claim benefit previously because [give reasons why you did not claim on the above date and throughout the period since this date.  Provide as much detail as possible about the issue(s) you are using to argue you had good cause throughout the relevant period for not claiming sooner].

I enclose a letter from [if possible enclose a supporting letter from someone like a doctor, support worker, health visitor, housing officer etc.].

I believe that the information provided above shows that I had ‘continuous good cause’ for not having claimed sooner (under Reg.83(12)(b)).

Please contact me if you need any more information.  

Yours faithfully



[Your name]

Enc: 	[describe any enclosed letters or documents]


E&W_HB_CLAIMANT_06
From claimant to housing benefits
Requesting backdate of housing benefit claim