Form
Use this claim form to apply for DLA for children under 16.
From:
Department for Work and Pensions
Published:
1 January 2013
Last updated:
21 April 2021, see all updates
Applies to:
Wales, England, and Scotland
PDF, 1.13MB
PDF, 2.38MB, 24 pages
Read about claiming Disability Living Allowance (DLA) for children before you apply.
Use a PDF reader to open and fill in this form. You can download a free PDF reader from your app store or from the internet.
If you are using screen reader software to access the form, we recommend that you review all of the notes and the questions on the form before you complete it. As you complete the form, you will be guided through the questions based on the responses you provide.
Do not use your device’s browser or, if you are an Apple Macintosh user, the Preview application.
You can save data typed into this form if you use a PDF reader. This means that you do not have to fill in the form in one session.
There are reliability issues with some assistive software, which may mean the form will not save properly.
This form will only save if it is both:
The form will not save in:
For help and advice on the information you need to put on the form or about DLA for children, contact the Disability Living Allowance helpline.
Contact the DWP Online Helpdesk, if you are having technical difficulties:
Email
dwponline.helpdesk@dwp.gov.uk
Telephone
0800 169 0154
Monday to Friday 8am to 6pm
Closed weekends and all public and bank holidays
Send the completed form to:
Disability Benefit Centre 4
Post Handling Site B
Wolverhampton
WV99 1BY
If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, fill in the online accessible format request.
Published 1 January 2013
Last updated 21 April 2021 + show all updates
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