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Your priority debts Total you owe Claimant Repayment offer Partner Repayment Rent arrears Mortgage arrears Council tax arrears Gas arrears Any other priority debts you are paying Total priority debt repayments Non-Priority Debts For example Credit Cards / Store Cards / HP / Loans etc Your non-priority debts. Signature of person completing this form Name of person completing this form Position / relationship Please return this form within four weeks of the date of issue to Revenues Benefits...
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Exceptional hardship payment claim is a request for additional financial assistance due to unexpected and severe circumstances.
Individuals who are facing extreme financial difficulties and are eligible for the program.
The form can be filled out online or submitted in person at the relevant government office.
The purpose is to provide temporary relief to those in dire financial situations.
Applicant's personal information, details of financial situation, reasons for requesting assistance.
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