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Dear Sir/Madam,<br />

Housing Benefit Regulations 1982<br />

SPECIMEN HOUSING BENEFIT<br />

NOTIFICATION FORM<br />

Your application has now been examined, and on the basis of the information<br />

contained therein, it has been deterrrdned that your rent and rates should be<br />

rebated, as per the under-noted details.<br />

(a) Rent Rebate L per week from Monday<br />

(b) Rate Rebate E per week from Monday<br />

(c) Housing Eenef it Supplement A per week from Monday<br />

(provisional) award<br />

(d) In accordance with the provisions of the abom Regulations you may, within<br />

one month, make representation against this determination.<br />

(e) You are required to inform the Rebates office staff of any change in the<br />

circumstances stated on your application form e.g. re. - members of the<br />

household, income, change of address.<br />

Yours faithfully,<br />

Director of Housing.<br />

WPIOO 1-10258<br />

102<br />

3’$$

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