How to complete this form

This form should only be completed for holidays you have taken but not been paid for.

Part 1: Security questions

Your answers must be the same as what you told us on your online claim. You will need the following information to hand:

• claim reference number
• National Insurance number

Part 2: Amendment section

Only answer a question if you need to change what you submitted in your online claim.

Leave questions blank that you do not want to change.

You will need the following information to hand:

• date your holiday year started
• number of holidays you were entitled to
• dates for holidays taken but not paid for

Start part 1