<Your address>
<Postcode>

14 April 2016

<Address of the Housing Benefit department>

Dear Sir/Madam,

Re: Request for backdated housing benefit – <insert your name and reference or account number> 
(You will find this on any letters from the Housing Benefit department.)

I am writing regarding my claim for housing benefit. I would like to request that my benefit be backdated to <the date you think that your benefit should be paid from>.

I was not able to claim benefit previously because <give the reasons why you did not claim on the date you think benefit should be paid from and why you have not claimed until now and provide as much detail as possible. >.

I enclose a letter from (if possible enclose a supporting letter from someone like a doctor, support worker or health visitor).

I believe that the information provided above shows that I had ‘good cause’ for not having claimed sooner and I request that my claim is backdated.

Please do not hesitate to contact me should you require any further information. Thank you for your assistance in this matter.

Yours faithfully,

<Your name>
< Contact telephone number>