Application / appeal form for the Secretary of State, HM Revenue and Customs and local authorities for social security, child support, tax credits and housing benefit and council tax benefit cases

Published date21 March 2018
subjectMatterAdministrative Appeals Chamber (Upper Tribunal) forms
OSSC1

UPPER TRIBUNAL

ADMINISTRATIVE APPEALS CHAMBER

Office stamp

(date received)

APPLICATION FOR PERMISSION TO APPEAL or

NOTICE OF APPEAL

from First-tier Tribunal (Social Entitlement Chamber)

This form is for use only by the Secretary of State, Her Majesty’s Revenue and Customs, the Child Maintenance and Enforcement Commission or a local authority (other than as a compensator).

Please

Use black ink

Use another sheet of paper if there is not enough space for you to say everything. (Please put the names of the Appellant and Respondent(s) at the top of the sheet.)

Complete the form in CAPITALS

A

About the Appellant

Is the Appellant the Secretary of State, Her Majesty’s Revenue and Customs, the Child Maintenance and Enforcement Commission or a local authority?

Secretary of State

Child Maintenance and Enforcement Commission

Her Majesty’s Revenue and Customs

Local authority

Name of authority

Please give details of the Appellant's representative to whom correspondence should be sent.

Name of representative

Address of representative

Postcode

Daytime telephone number

Reference no. (if any)

B

About the Respondents

First Respondent

Surname

Other names

Address

Postcode


B (continued)

About the Respondent(s)

Second Respondent

(if any)

Surname

Other names

...

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