Fill - Free fillable SSCS5 Notice of appeal against a decision of (Cabinet Office) PDF form

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

Benet, 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 conrm that you have attached a copy of the

mandatory reconsideration notice with your appeal form.

Now go to Section 2

Yes No

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 benet you are

appealing about. The name of the benet will be shown on the letter

giving you the decision.

Reset form

Print form

Reset form

Print form

Page 2

Section 2 ABOUT YOU

Mr Mrs Miss Ms Other (please specify)

First name(s) Surname

Now go to Section 3

Address

Postcode

Daytime phone number

Mobile phone number

National Insurance number*

letters numbers

letter

Date of birth (DD/MM/YYYY)

/ /

* If you are appealing on behalf of a child or other person and

you have provided their National Insurance number in

Section 3, you do not need to provide your own National

Insurance number.

Section 3 ABOUT A CHILD OR OTHER PERSON YOU ARE APPEALING FOR

First name(s) Surname

Address (if the person’s address is dierent from your own)

Postcode

Are you appealing on behalf of a child or other person

whose aairs you have been appointed to take care of?

Yes If Yes, please tell us about the person below

No If No,

please go to Section 4

Now go to Section 4

Fill in this section if the decision you are appealing against is about your award or benet or the award or benet of a

person you have been appointed by HMRC or a court to take care of. If you are appointed by HMRC or a court to take

charge of another person’s award or benet, you should also record their details in Section 3.

This section is for people who are making an appeal on behalf of someone they have a legal responsibility for. This might be

a parent acting for a child or a person who has been appointed by HMRC or a court to look after the aairs of another adult.

Mr Mrs Miss Ms Other (please specify)

National Insurance number

letters numbers

letter

Date of birth (DD/MM/YYYY)

/ /

Page 3

Section 4 ABOUT YOUR REPRESENTATIVE (If you have one)

Do you have a representative?

Yes If Yes, please tell us about the person below

No If No,

please go to Section 5

First name Surname

Name of organisation or of person representing

Address

Postcode

Now go to Section 5

Phone number

If you are being represented by an organisation and you know the

name of the person acting on your behalf, please tell us below

This section is about your representative (if you have one).

By representative we mean someone acting on your behalf in a formal capacity. This might be an organisation like the

Citizens Advice or a welfare rights service or it may be a friend or advisor who knows about Tax Credit, Child Benet or

Guardian’s Allowance, Tax-Free Childcare or 30 hours’ free Childcare matters. If you name a representative here and give

your signature at Section 8, this will authorise us to deal with your representative about your appeal. If you are unsure

about this, please read the section ‘About Your Representative’ in the guidance booklet SSCS5A.

Mr Mrs Miss Ms Other (please specify)

Page 4

Section 5 ABOUT YOUR APPEAL

Grounds for appeal

In this section we need to know why you are appealing. Please write down in your own words the reasons why you

disagree with HMRC’s decision. You do not have to use BLOCK CAPITALS in this section if your handwriting is clear. If you

do not complete this section this will delay dealing with your appeal and the appeal form may be returned to you. For

more information on grounds for appeal please refer to the ‘About Your Appeal’ section of the guidance booklet SSCS5A.

Is your appeal in time?

According to the law, your appeal must be received by the tribunal no later than one calendar month after the date the

mandatory reconsideration notice was sent to you. If your appeal is received after this date, it is a late appeal and the

tribunal will need to know why it is late.

Is your appeal late?

Yes If Yes, you must give reasons below why your appeal is late

No If No,

please go to Section 6

If your appeal is late, you must give an explanation why. The tribunal will consider your reasons and can extend the time

limit for you. If you do not give reasons why your appeal is late your appeal form may be sent back to you. Please tell us

below why your apeal is late. You do not need to use BLOCK CAPITALS.

(if necessary, continue on a separate sheet)

HM Revenue and Customs has the right to object to a late appeal. The tribunal will consider any objection they make and

we will let you know the outcome.

Page 5

Now go to Section 7

Condentiality

Normally there are only two parties to the appeal, you and HMRC. Clearly HMRC will know all about you.

However, sometimes the dispute you have with HMRC may involve another person.

For example both parents (or another adult) may be claiming Child Benet. In such cases that other person might be

joined as a party to the appeal.

As that other party has a right to see all the evidence submitted as part of the appeal there will be occasions when

certain types of evidence, such as bills or bank statements are received which will include your home address. The other

party to the appeal will have the right to see this evidence. If, however, you do not want the other party to know your

current address (and they do not already know it), you can ask for your address to be kept condential. If you do this, any

piece of evidence received relating to you will be scrutinised by HMCTS sta and will be edited to remove all address

details before it is circulated.

I want my home address to be kept condential.

Yes

Section 6 ABOUT YOUR CHOICE OF HEARING

I want to attend a hearing of my appeal If you have ticked this box,

please go to Section 7

I want my appeal decided on the papers If you have ticked this box,

please go to Section 8

Appeals are considered by an independent panel. We will make arrangements for your appeal to be heard by the panel and

you or your representative will be expected to attend the hearing. If, however, you do not wish to attend a hearing you can

ask for your appeal to be decided on the papers. Please tell us below how you would like us to deal with your appeal.

If you change your mind about this, you must tell us as soon as possible as it may be too late to change this once the

hearing has been arranged. For more information, please refer to the ‘About Your Choice of Hearing’ section in the

guidance booklet SSCS5A.

Page 6

Section 7 THE HEARING — YOUR NEEDS AND REQUIREMENTS

You only need to answer these questions if you told us in Section 6 that you wanted to attend a hearing. If you have

asked for your appeal to be decided on the papers, please skip this section and go straight to Section 8.

In this section we need to ask you a number of questions to help us arrange a suitable hearing for you. We will try to

accommodate your needs and availability, but it may not always be possible to do this. Please answer questions 1 to 4 to

give us the information we require. If you do not answer some of the questions we will have to contact you again and this

may delay your appeal. You do not have to answer these questions using BLOCK CAPITALS.

Question 1 – Your availability

Tribunal hearings are held Monday to Friday from 10am to 5pm and in our larger hearing centres also on Saturday.

To allow you to attend your hearing, we will try to arrange a time and date in line with your availability. It is important

that you tell us here if there are any days of the week or times of the day when you cannot attend a tribunal or any dates

when you are unavailable because of things like booked holidays and hospital appointments. You should consider your

availability for the six months ahead.

Are you available to attend a hearing at

any time?

Yes

No If No, please tell us when you cannot attend in the box below

Question 2 – Your needs

Please tell us here about any special needs you may have which we need to take into account when arranging your hearing.

This might be things such as hearing loops or disability access.

Do you have any special needs?

Yes If Yes, please tell us about this in the box below

Question 3 – Your signer or interpreter and language requirements

Do you require an interpreter or signer to assist you at the hearing?

Yes If Yes,

please tell us the language and dialect required below

Language or type of sign language interpreter Dialect

We will arrange for a professional interpreter to be present at the hearing. Please refer to the section ‘Completing

form SSCS5’ in the guidance booklet SSCS5A for more information about interpreters.

Question 4 – Your notice of hearing

We will usually give you at least 14 days’ notice of the date of the hearing. If you agree, we can also give you less than

14 days’ notice. This may allow the hearing to be arranged more quickly if, for example, another hearing is cancelled and

yours can replace it at short notice.

Do you agree to receiving less than 14 days’ notice of a hearing?

Yes No

Now go to Section 8

Page 7

Section 8 YOUR SIGNATURE

Signature Date (DD/MM/YYYY)

/ /

Name

If you are a representative signing this form on behalf of the person who is appealing, you must send their signed

authority for you to act on their behalf with this form.

You must sign your appeal form for it to be valid. If you have named a representative in Section 4, your signature will also

give HMCTS your authority to deal with them when they contact us on your behalf.

WHAT TO DO NOW

You need to send your appeal form and a copy of the mandatory reconsideration notice to

HM Courts & Tribunals Service.

If you live in England or Wales send your appeal to:

HMCTS SSCS Appeals Centre

PO Box 1203

BRADFORD

BD1 9WP

If you live in Scotland send your appeal to:

HMCTS SSCS Appeals Centre

PO Box 27080

GLASGOW

G2 9HQ

We will send you a letter to tell you we have received your appeal and explain what happens next.

CHECKLIST

You may nd this checklist useful to help you make sure you have given all the information we need.

I have included a copy of the mandatory reconsideration notice (Section 1)

I have given grounds for my appeal (Section 5)

I have chosen the type of hearing I want (Section 6)

I or my representative have signed my appeal form (Section 8)

Alternative Formats

If you need this form in an alternative format, for example in large print, please call 0300 123 1142 (English language

speakers), or 0300 303 5170 (Welsh language speakers) if you live in England or Wales and 0300 790 6234 if you live in

Scotland.

The Ministry of Justice and HM Courts and Tribunals Service processes personal information about you in the context of

tribunal proceedings.

For details of the standards we follow when processing your data, please visit the following address

https://www.gov.uk/government/organisations/hm-courts-and-tribunals-service/about/personal-information-charter

To receive a paper copy of this privacy notice, please call 0300 123 1024/ Textphone 18001 0300 123 1024. If calling from

Scotland, please call 0300 790 6234 Textphone 18001 0300 790 6234.

Reset form

Print form

Reset form

Print form

Download
Save PDF to desktop

Email
Email completed PDF

Send for Signing
Email for others to sign

Print
Print document

NAME

SSCS5 Notice of appeal against a decision of (Cabinet Office)

View Audit Log
Print With Audit Log
Duplicate Document

Fill Online, Printable, Fillable, Blank SSCS5 Notice of appeal against a decision of (Cabinet Office) Form

Related forms

Fillable SSCS5 Notice of appeal against a decision of (Cabinet Office)

Fill Online, Printable, Fillable, Blank SSCS5 Notice of appeal against a decision of (Cabinet Office) Form

Related forms

First 20 documents completely FREE!