Employment and Support Allowance claim form
Employment and Support Allowance (ESA) claim form.
Ref: ESA1 PDF, 1.41MB, 63 pages
Ref: ESA1-print PDF, 177KB, 62 pages
Ref: ESA1W PDF, 213KB, 62 pages
Published: 1 April 2013
Updated: 2 March 2017
- Published revised ESA claim form you can print and fill in with a pen – English and Welsh.
- Published revised ESA claim form you can download, fill in on screen, save – and then print.
- Expanded notes section to inlcude advice for claimants who have claimed ESA before.
- Added updated versions - Oct 2013.
- First published.