Application For Housing Benefit, Local Housing Allowance And Council Tax Reduction - Carmarthenshire County Council Page 28
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32Part 14
Declaration
Even if someone else has filled in this form for you, you must sign this declaration if you can.
If you have a partner, they must also sign to confirm all the details about them are correct.
Please read this declaration carefully before you sign and date it.
I/We understand the following:
• If I/We give information that is incorrect or incomplete, you may take action against me/us. This
may include court action.
• You will use the information I/We have provided to process my/our claim for Housing Benefit or
Council Tax Reduction, or both. You may check some of the information with other sources as
allowed by the law.
• You may use any information I/We have provided in connection with this and any other claim for
social security benefits that I/We have made or may make. You may give some information to
other organisations, such as government departments, local authorities and private-sector
companies such as banks and organisations that may lend me/us money, if the law allows this.
I/We know I/We must let the Housing Benefit Section know about any change in my/our
circumstances (see overleaf), which might affect my/our claim. I/We declare the information I/We
have given on this form is correct and complete.
Signature of person claiming
Date
Partner’s signature
Date
If this form has been filled in by someone other than the person claiming. Please tell us why you
are filling in this form for the person claiming.
As far as possible, I have confirmed with the person claiming that the answers I have written on
this form are correct.
Name of the person who filled in the form ....……………………………………………………………………
Signature of the person
Relationship to the person claiming
Date
Housing Benefits, Ty Elwyn, Llanelli, Carmarthenshire SA15 3AP. Tel: (01554) 742100
28
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