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Full Name Date of Birth Relationship to you
y
y"
If you are an Owner Occupier, a Council Tenant, A Council Boarder or a Rent Free
Tenant, you do not need to complete any more of this form. Please sign and date the
declaration at the end of the form - Go to Part 4.
If you are a tenant of a Housing Association please also provide your tenancy
agreement. You do not need to complete any more of this form. Please sign and date
the declaration at the end of the form - Go to Part 4.
If you are a tenant of a Private Landlord, please provide your tenancy agreement,
answer the questions in Part 3 and then sign the declaration at the end of the form.
16