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Reconsideration Letter

[Your Name] [Your Address]

Request for Reconsideration
[address on decision letter]

[date that you've written letter]

Dear Sir/Madam

Request for Reconsideration
National Insurance Number: [your National Insurance Number]
Decision in respect of [the name of the benefit you've been refused]
Decision Dated: [the date on the decision letter]

I would like you to look again at your decision as above, as I think that it is wrong. The reasons why I disagree with the decision are as follows:

[the reasons why you disagree]

I include the following extra evidence for you to take into consideration: [included any other extra evidence if you have it]

Thank you for your assistance. If you have any questions please contact me on [your phone number].

Yours faithfully

[sign here]

[print your name]