South Derbyshire District Council - Application form download

You can download the application form below. If you download and intend to complete the form, then please also fill in the registration form at the bottom of this page. Your intention to claim will then be registered. You will then have up to one month to return your claim form without losing benefit. If you do not complete this registration form, your claim will normally be paid from the Monday following the date the form is received in the office.

Alternatively you can ask us to post you an application form.

More about making a claim - Housing Benefit and Council Tax Benefit

If you need help understanding or filling in this form, phone Customer Services on 01283 595795 or you can visit ourcustomer services department.

Housing Benefit and Council Tax Benefit - application form download

South Derbyshire District Council - Registration of intention to claim

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