Benefits Review Request

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Customer Details

1. If you need clarification on the Benefits Review process, please see our Reviews, Appeals and Complaints page
2. Please note that if you navigate away from this form the information will not be saved and you will have to start again.
3. Your Benefit Claim Reference
4. Date of Birth
5. National Insurance Number
6. Please tick the box if you are completing this form on behalf of the claimant.

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