Form SSCS5
| Published date | 21 March 2018 |
| Subject Matter | Social security and child support forms |
Page 1
Tax Credits, Child Benefit and Guardian’s Allowance
Notice of appeal against a decision of
HM Revenue and Customs
You should use this form to appeal against a decision made by HM Revenue and Customs (HMRC) about Tax Credit, Child
Benet, Guardian’s Allowance or Tax-Free Childcare, or 30 hours’ free Childcare. If you need this form in an alternative
format, please see the note on page 6 of this form.
Further guidance to help you ll in this form is available in booklet SSCS5A 'How to appeal against a decision made by
HM Revenue and Customs'. You can download the booklet or nd out where it can be obtained from by visiting the justice
website www.justice.gov.uk
About this form
This form helps you provide all the information the tribunal requires to register your appeal. It will also ensure that your
appeal contains all the necessary details which the law requires.
How to ll in this form
Please use black ink to ll in this form and use BLOCK CAPITALS unless the form tells you not to.
You must complete Sections 1, 2, 5, 6 and 8
If you want to attend a hearing, you must also complete Section 7
If you are appealing on behalf of someone who a court or HMRC has appointed you to act for, you must
also complete Section 3
If you have a representative, you must also complete Section 4
What to include with this form
You must include a copy of the mandatory reconsideration notice which shows the decision you are appealing
against. You do not need to include evidence/information you have already sent to HMRC as they will send it to us as part
of their response.
Section 1 ABOUT THE DECISION YOU ARE APPEALING AGAINST
Does your mandatory reconsideration notice tell you that you
have the right to appeal against the decision?
If No, please ensure you have read the section ‘Can I Appeal?’ in
the booklet SSCS5A ‘How to appeal against a decision made by
HM Revenue and Customs’ before continuing with this form.
Please tick this box to conrm that you have attached a copy of the
mandatory reconsideration notice with your appeal form.
Now go to Section 2
Yes No
SSCS5 - Notice of appeal agains t a decision of HM Revenue and Customs (01.19) © Crown copyright 2019
SSCS5
This section is about your mandatory reconsideration notice. This is the letter sent to you by HMRC explaining that
they have looked at your decision again.
Remember to include a copy of your mandatory reconsideration notice with your appeal form.
If you do not do so, we will be unable to register your appeal until this is provided.
Please write here the name of the award or benet you are
appealing about. The name of the benet will be shown on the letter
giving you the decision.
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