This form can be used by a creditor to request a third party deduction from a Universal Credit claimant.
There is a different form for landlords to use to request a third party deduction to cover rent arrears
This form can only be used by a creditor to request a third party deduction from a Universal Credit claimant who has:
Send the completed form to:
Post Handling Site B
4 June 2015
Department for Work and Pensions
Deductions from benefit: guidance for creditors
Don’t include personal or financial information like your National Insurance number or credit card details.