Special Benefit Review form (BC048m)

Use this form to confirm your details if you are receiving a special benefit so we can check that you are receiving the right amount.

Please fill in your name, address, Customer Reference Number (CRN), the date of issue and the return date on the first page of the form. If you do not know the return date, please contact us so that you can return the review by the due date.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 30 August 2018