Compensation Recovery Statement of Financial Circumstances form (SS484)

Use this form to tell us when you’re in financial hardship and want a review of your compensation payments.

Download and complete the Compensation Statement of Financial Circumstances form.

To fill in this form digitally you will need a computer and Adobe Acrobat Reader, or a similar program. You can download Adobe Acrobat Reader for free. If you can’t complete the form digitally, you can print it, complete it by hand and return it to us following the instructions on the form.

If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please use self service, request someone to deal with us on your behalf, or contact us. We can help you access, complete and submit them.

Page last updated: 6 June 2024.
QC 62212