Housing Benefit And Council Tax Reduction Change Of Address Form Page 9
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16Part 5a If you pay rent to a housing association or you
do not qualify for Local Housing Allowance - continued
Your landlord’s declaration
I agree to accept Housing Benefit payments for the tenant named in this form.
I understand that by law:
• I must tell you straight away if I find out about any change in the tenant’s circumstances;
• you can stop paying benefit to me if I do not tell you about any change in the tenant’s circumstances;
• I can be prosecuted if I accept Housing Benefit which I know I am not entitled to; and
• if you pay me too much Housing Benefit for any tenant, I may have to repay it. You can take the amount
of overpaid benefit from the benefit I get for any other tenants. This will not affect their rent.
Landlord’s signature
Date
Now go to part 6.
Part 5b If you get Local Housing Allowance
Under the Local Housing Allowance (LHA) scheme, we will usually pay benefit to you, the tenant. You
must then pay the rent to your landlord yourself.
Please provide details of your bank or building society account.
Name of your bank or building society
Address of your bank or
building society
Account number
Sort code
Roll number
Building society accounts only
If you think that getting Local Housing Allowance will cause you serious problems, we may be able to
pay your LHA to your landlord. We will need to decide if you are having, or are likely to have, problems
managing your money and paying your rent. Please contact our benefits call centre team on 020 8356
3399 for more information and advice.
Your declaration
Please pay my Housing Benefit straight to my landlord.
• I understand that I must always tell you about any change in my circumstances.
• I understand that if I do not tell you about any changes in my circumstances and you pay me too much
benefit because of this, I may have to pay back the extra benefit.
• I understand that I may be prosecuted if I do not tell you about any change in circumstance.
Signature
Date
Full name
(in CAPITAL LETTERS)
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