Our Privacy Statement.
Complete the form below and click 'submit'. We will forward the details on to the Department of Works and Pensions on your behalf.
Your Name:
Your husband wife partner's name:
Address:
Postcode:
Telephone Number
Email Address:
National Insurance Number (if known):
Date of Birth:
By clicking the 'submit' button below, you consent to the Department for Work and Pensions supplying details of your claim to Durham Welfare Rights Team.
They will consider backdating your claim for the maximum allowed by law.
Alternatively, you can print this page, complete your details and send the form to:
Welfare Rights Team Moor Chambers 26 Front Street Framwellgate Moor Durham DH1 5EJ Telephone: 0191 384 4252
