Form

Employment and Support Allowance: permitted work form

Use this form to tell us if you are working, or want to work, while claiming Employment and Support Allowance (ESA).

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If you’re claiming ESA, fill in the permitted work form before you start any paid or unpaid work.

Send it to the Jobcentre Plus office that deals with your benefit. They will tell you if the work you want to do meets the permitted work conditions.

You could lose your benefit if you do any kind of work that doesn’t meet the conditions. If you can’t send the form before you start work, send it as soon as possible after starting work.

If you can’t use this PDF form for any reason, contact the office that deals with your benefit.

Published 3 April 2017