Council Tax - Application For Status Discount For Students (Page 2 of 2) in pdf

COUNCIL TAX- STATUS DISCOUNT FOR STUDENTS

APPLICATION DETAILS

SECTION B

(Please complete in Block Capitals)

Applicant’s Name______________________________

Reference Number (shown on the bill)

Address_____________________________________

____________________________________________

Date of Birth of Student if under 20

____________________________________________

Telephone Number for contact____________________

How many people aged 18 or over (including yourself) usually live in the property?

How many of those people are eligible for a status discount? (see Section D )

Full name of the Student

Name and Address of the School/College/

Polytechnic or University attended.

Date started course_______________________________

Date to cease course__________________________

Apprentices only:

Name and address of your Employer

(Please also enclose a letter from your employer

confirming your earnings are less than £195 pw gross)

DO NOT FORGET TO ENCLOSE YOUR CERTIFICATE OR IF AT SCHOOL YOUR LETTER OR CHILD BENEFIT DETAILS.

SECTION C

DECLARATION

As far as I know all the information I have given is accurate and true. I agree to tell the Council immediately if the

circumstances change or I think that any reduction given as a result of this application should not apply.

Name_______________________

Signed____________________________

Date_____________________

SECTION D

PERSONS ELIGIBLE FOR DISCOUNT

The following are categories of people who qualify for a ‘status’ discount.

“Calderdale MBC will ensure that any personal information provided

Please put a tick in the appropriate box if you think that anyone else living

by you on this form will be treated in accordance with the provisions

at the property may qualify. An application form will be sent to you.

of the Data Protection Act 1998. Calderdale MBC is the Data

[ ]

Persons in detention

Controller of the information you have provided on this form and is

[ ]

The Severely Mentally Impaired

registered with the Information Commissioner’s Office for the

[ ]

Persons over 18 in respect of whom child benefit is payable

purposes of processing your personal information in relation to your

[ ]

Students

application.

[ ]

Apprentices

The Council must protect the public fund it handles and so may use

[ ]

Student Nurses

the information you have provided on this form to prevent and detect

[ ]

Youth Training Trainees

fraud. The Council may also share this information, for the same

[ ]

Hospital Patients

purposes, with other organisations which handle public funds. The

[ ]

Patients in Nursing or Care Homes

Council will not share your information for any other purpose

[ ]

Carers

without your explicit consent.

For further information about Data Protection please email

[ ]

Residents of Hostels

[ ]

Members of Religious Communities

the Council’s Information Manager on

[ ]

Persons with a relevant association with a visiting force

information.management@calderdale.gov.uk

[ ]

Members of International Headquarters and Defence

Organisations

SECTION E

FOR OFFICIAL USE

Granted From____________________________ Granted To__________________________________

Date_____________________

Council Tax - Application For Status Discount For Students Page 2

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