From [Your Address]
[The address on the Jobcentre Plus letter] Date
Dear Sir/Madam
APPEAL
Your Ref: [Your National Insurance Number]
JSA Entitlement Decision Dated: [The date at the top of the Jobcentre Plus’s letter]
JSA Sanction Decision Dated: [The date at the top of the Jobcentre Plus’s letter]
I wish to appeal your decisions as follows:
1. Your decision to end my Jobseeker's Allowance
2. Your decision to apply a sanction.
This is for the following reasons:
[Give the reasons why you think it was wrong to end your Jobseeker's Allowance and to apply a sanction]
Yours faithfully
[Your signature]
[Your name]
[ A contact telephone number, if you have one]