Housing Benefit And Council Tax Support Claim Form Page 13
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32Claim_rev 39
17/9/09
22:23
Page 13
Part 10 Income from boarders, lodgers and subtenants
A boarder or lodger is someone who pays rent which includes meals. A subtenant is someone who rents out part of your
Proof
home, who is not a member of your family and whose rent does not include any meals.
needed
Please send us proof, such as a payment card or letter for any subtenants or boarders or lodgers.
Do you rent out part of your home to
Answer Yes or No
any boarders or lodgers?
If No, go to part 11.
If Yes, please give us the following information.
How many boarders or
lodgers live with you?
Please give the boarders’ or lodgers’
£
e
c a
h
w
e e
k
names and the amount you charge
each week.
£
e
c a
h
w
e e
k
£
e
c a
h
w
e e
k
£
e
c a
h
w
e e
k
Does this include a
Answer Yes or No
charge for heating?
Do you rent out part of your home to
Answer Yes or No
anyone who is a subtenant?
If Yes, how many subtenants?
Please give the subtenants’ names and
£
e
c a
h
w
e e
k
the amount you charge each week.
£
e
c a
h
w
e e
k
£
e
c a
h
w
e e
k
£
e
c a
h
w
e e
k
Does this include a
Answer Yes or No
charge for heating?
If you have used a separate sheet of paper, write ‘Part 10’ at the top of it, sign and date it and tick this box.
Part 11 Other money you or your partner have coming in
You must use this part to tell us about all other sources of income that you have not shown in earlier sections. You should include anything you or
your partner receive, for example, a private or work pension, any winnings or other unusual sources of income.
This also includes any maintenance or child support for you, your partner or any other children you have told us about in this form, and any other
cash payments. Also tell us about any money you receive from the Territorial Army or a charitable trust or because you are a local authority
councillor. You do not need to tell us about payments from the Independent Living Fund, the Eileen Trust or the McFarlane Trust.
Proof
You must send us proof of any money you have coming in before we can decide how much benefit you can get.
needed
About you
About your partner
Do you or your partner have any money
coming in that you have not already
Answer Yes or No
Answer Yes or No
told us about on this form?
If you have answered No to the questions above, for both you and your partner, go to part 12.
If you have answered Yes for you or your partner, answer the questions on the following page.
Lambeth Revenues and Benefits, Olive Morris House, 18 Brixton Hill, London, SW2 1RD
Page 13 of 32
Phone: 0845 300 0328
Website:
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