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, 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.

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Page last updated: 27 August 2017