Benefit enquiry form

Title * - Select -MrMrsMissMsDrCouncillor

Forename *

Surname *

Address *

Address

Address

Postcode *

Enquiry *

Please provide details of your enquiry in this section.

Email

Please provide an email address if you have one.

Phone number *

Data protection

For the purposes of the Data Protection Act 1998, the Data Controller in relation to any personal data you supply is Selby District Council. Any personal information provided on this form and any supporting information you send to us will be processed and stored by Selby District Council in accordance with the principles of the Data Protection Act. Any information will be used for the purpose of this Service Request only. It may be necessary to share information with other agencies or organisations such as the Department for Work and Pensions and Inland Revenue as allowed by law. We may check information you have provided or information about you that someone else has provided with other information held by us. We may also get information about you form certain third parties, or give the information to: make sure the information is accurate, prevent or detect crime and protect public funds. These third parties include Government Departments and local Authorities.

Privacy policy *

I agree with the above statement