Claim for Special Benefit form (SU004)

Use this form to claim Special Benefit if you are in severe financial hardship due to circumstances beyond your control.

If you use assistive technology because of a disability or impairment we provide help for assistive technology users of forms.

Page last updated: 9 February 2017

This information was printed Saturday 25 March 2017 from It may not include all of the relevant information on this topic. Please consider any relevant site notices at when using this material.