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Online Benefit Fraud Form

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Who do you suspect is committing the Fraud?
Title:
Gender:
First Name:
Surname:
Nickname/Aliases
Address:	-- Enter Text --
Home Telephone Number:
Work Telephone Number:
Date of Birth:
Age:
National Insurance No:

Contact Information

If you require further information or you would like help completing the application form please contact the Benefits section at:-
South Bucks District Council
Capswood
Oxford Road
Denham
Bucks
UB9 4LH

Tel: Benefits helpline 01895 837515
Email: fraud@southbucks.gov.uk.

Section 2 Type of fraudulent activity

When did the fraud start?	-- Enter Text --
Why do you think the claim is fraudulent?	-- Enter Text --

What type of fraud is being committed?

Other:

Section 3 Living arrangements

What address do you think they are actually living at?	-- Enter Text --
Does the Landlord know?
If Yes why do you think so?
Do they intend to come back?
Is the property being sub-let?
If Yes, to who?

Section 4 Employment

How do they get to work?
At what time do they leave home?
When do they work?	-- Enter Text --

Does their employer know that they haven't declared the work?
Vehicle details:
Car make / model:
Car registration:
Car colour:

Section 5 Income

What other income haven't they declared?Label	-- Enter Text --
Where is this from? e.g. trust funds, rent.

Section 6 Capital Investments

What other capital do they have?
How much is this worth?
Where is this capital - Bank, Building Society, second property?

Section 7 Details of partners

First name of partner:
Surname of partner:
Date of birth of partner:
Do they work?
If Yes, where do they work?
What hours do they work?	-- Enter Text --
How long hs the partner been living there?


Section 8 Other people in the house

First name:
Surname:
Age:
Date of birth:
What is their income?

Section 9 Living as a couple with the landlord

Landlord's first name:
Landlord's Family name:
How long have they been living as a couple?
Does landlord know about the benefit claim?

Section 10 Landlord is a close relative and is living in the same property

Landlord's first name:
Landlord's Family name:
What is their relationship?
Does relation know of the benefit claim?

Section 11 Any other information
Please enter below any other information you think may be useful.	-- Enter Text --