Complete this form and take or send it to us

• Use the space on the next page to say why you do not agree with the decision.
• You must say why you think the decision is wrong. It is not enough to say 'I do not agree with the decision' or 'The money is not enough'. The reasons given should be like these examples:
  • 'My rent was £75 per week but you have stated that it was £35 per week'.
  • 'I moved into a property on 1 November not 1 December'.
  • 'You have used the wrong wages to work out my benefit. I received £250 only during the Christmas week'.
• If you are appealing against more than one decision, state why you do not agree with each one.
• If you are appealing more than one month after the decision was made, you must say why your appeal has been delayed.

• Use this space to say why you do not agree with the decision.
• You must say why you think the decision is wrong.
  Use BLOCK CAPITALS

• If you need more space, use another sheet of paper. Remember to put your name and NI number on any extra sheets of paper.

If someone has been officially appointed to act for you or someone has the authority to act for you, they should sign here.

• Make sure you have said above why you do not agree with the decision.
• Make sure you have filled in all parts of this form and signed it.
• Take or send this form to
  Wychavon District Council, Civic Centre, Pershore, Worcs, WR10 1PT.
• It will help if you write Appeal on the front of the envelope.
• Remember, your appeal must reach the office within one month of the date at the top of the letter telling you about the decision.
• If you need further details please phone us on 01386 565000 or e-mail revenues@wychavon.gov.uk