Housing Benefit And Council Tax Support Claim Form Page 9
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18Part G
Questions for people who pay rent
If you would like help with your rent, please fill in this section. If not, please go to Part J.
1.
Are you a council tenant?
Yes
No
/
/
!
2.
What date did your tenancy start?
!
3.
How much is the full rent?
!
4.
How often is the rent charged?
/
/
5.
What was the date of the most recent rent increase?
/
/
6.
When is the next rent increase due?
7.
What period of notice to vacate the property is required?
8.
Does anyone else share the rent with you and your partner?
Yes
No
If ‘Yes’, tell us their names, the
%
percentages of rent they pay
and their relationship to you and
%
your partner (if you have one).
9.
Do you have any weeks when
Yes
No
If ‘Yes’, how many?
you do not have to pay rent?
10.
Were you able to afford the rent when you took on the tenancy?
Yes
No
11.
Have you or your partner received Housing Benefit in the last 52 weeks?
Yes
No
12.
Are you behind with your rent?
Yes
No
If ‘Yes’, how much?
13.
Does your rent include any of the following, please tell us the amount or tick the box if you don’t know
the amount. Leave blank if your rent does not include any of these items.
Service
If included,
Service
If included,
how much?
how much?
Heating
Water rates
Lighting
Personal care and support
Hot water
Cleaning of accommodation
Fuel for cooking
TV Licence
Laundry
Gardening
Garage
Other
14.
Does your rent include?
Breakfast
Part Board
Full Board
15.
If you rent a garage, is it part of your tenancy?
Yes
No
Page 9
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