Housing Benefit Clam Form And Council Tax Reduction Page 3

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Page 3
Part 1 About you and your partner – continued
You
Your partner
Have you or your partner
No
No
claimed Housing Benefit or
Council Tax Reduction before?
Tell us about this
Tell us about this
Yes
Yes
below
below
/
/
/
/
When did you claim?
Which council did you claim
from?
What address did you claim
for?
Postcode
Postcode
When did you move out of this
/
/
/
/
address?
Have you told the council
No
No
that paid your benefit that
you have moved?
Yes
Yes
Do you or your partner get
No
No
Disability Living Allowance?
Yes
Yes
How much?
How much?
Higher rate: £
Higher rate: £
Care component
Middle rate: £
Middle rate: £
Lower rate: £
Lower rate: £
Mobility component
Mobility:
£
Mobility: £
Do you or your partner get
No
No
Personal Independence
Payment?
Yes
How much?
Yes
How much?
Enhanced rate: £
Enhanced rate: £
Daily Living
Component
Standard rate: £
Standard rate: £
Mobility component
Mobility:
£
Mobility:
£
Do you or your partner get
No
No
Attendance Allowance?
Yes
Yes

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