Council Tax Single Person Discount Application (Page 2 of 2) in pdf

Council Tax Single Person Discount Application Page 2

If you are now the only adult resident as a result of another adult leaving the property, please provide

details of their move.

Their full name(s):

Date they left the property:

Their new address:

What is their interest in their new address?

Owner

Tenant

Lodger

Other

(Please give details)

_________________________________________________________________________________

Is the change permanent?

Y/N

If NO, what is the nature of their absence and when do they intend to return?

Have they removed the majority of their possessions from the property?

Y/N

If no, please explain reason __________________________________________________________

Do they have any ongoing legal interest in the property they have vacated?

Y/N

If YES, is there any intention to remove their name from the title of the property/tenancy?

Y/N

Any other information you may wish to provide

DECLARATION

As far as I know, the information I have given is accurate and true. I understand that to supply

false information may result in prosecution.

I authorise the Local Taxation Office to make any enquiries necessary to verify the information

given.

I undertake to notify the Local Taxation Office when the property is occupied by more than one

adult as their sole or main residence. I understand that failure to do so, within 21 days, may

result in a £70.00 penalty

Your Signature______________________________________________

Date______________________

Daytime Telephone Number__________________________________

(You do not have to give a telephone number, but it would be helpful in case clarification is

needed)

Council Tax Single Person Discount Application Page 2