IRRV Alert - week ending 28th August 2020
News
Consultations
Reports
Income-related or contribution-based Employment and Support Allowance (ESA) claim form (27 August 2020)
Form
Income-related or contribution-based Employment and Support Allowance (ESA) claim form
- English
- Cymraeg
Only complete this form if you are asked to. You may need to apply for Universal Credit or New Style ESA instead.
Published 1 April 2013
Last updated 27 August 2020 — see all updates
From:
Department for Work and Pensions
Applies to:
Wales, England, and Scotland
Documents
ESA claim form you can download, fill in on screen, save and then print
Ref: ESA1PDF, 1.64MB
ESA claim form you can print and fill in with a pen
Ref: ESA1-printPDF, 1.69MB, 64 pages
ESA renewal claim form (if you got ESA in the last 12 weeks) you can download, fill in on screen, save and then print
Ref: ESA1RRPDF, 1.78MB, 28 pages
ESA renewal claim form (if you got ESA in the last 12 weeks) you can print and fill in with a pen
Ref: ESA1RR - printPDF, 1.59MB, 28 pages
Details
Do not complete this form unless you are asked to.
Find out how to claim income-related or contribution-based Employment and Support Allowance.
Published 1 April 2013
Last updated 27 August 2020 + show all updates