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Council Tax Student Discount / Exemption Application Form - Gateshead Council,united Kingdom Page 2

SECTION 2 – Student(s) Details

Start Date of

End Date of

Name of Student

Name of College

Course

SECTION 3 – Details of any Non-British Spouse / Dependant(s)

1. Name of Non-British Spouse / Civil

Partner / Dependant(s)

2. Date they moved in

Do the terms of their entry visa to UK prevent them from taking paid

Yes

employment or from claiming benefits? If `Yes` please supply a copy of visa confirming this

IMPORTANT

IN ORDER TO AWARD THE DISCOUNT / EXEMPTION YOU MUST PROVIDE A STUDENT

CERTIFICATE FOR EACH STUDENT. STUDENT CERTIFICATES CAN BE OBTAINED

FROM YOUR COLLEGE / UNIVERSITY ADMINISTRATIONS OFFICE. PLEASE NOTE

GRANT DETAILS, ENROLMENT FORMS OR ADMISSION DOCUMENTS WILL NOT BE

ACCEPTED AS PROOF OF STUDENT STATUS.

SECTION 3 – Declaration

Please note that any discount or exemption will only be awarded on the basis of your current

circumstances. You will be required to inform the Council within 21 days should there be a change,

for example if another adult enters your household. If you fail to report any such change this could

result in a fixed penalty being imposed on you, in addition to the recovery of any overpaid discount

r exemption.

I declare that the information stated on this form is true and accurate to the best of my knowledge

nd belief

Signature

Date

Print name

Telephone

E-mail

Please return completed form with your student certificate to -

Gateshead Council, Council Tax Dept, Civic Centre, Regent Street, Gateshead, NE8 1HH

In accordance with Data Protection Law we may use any information you give us to prevent or detect fraud or other

crimes. We may also share information with other Council services or public organisations if required by law to do so.

Council Tax Student Discount / Exemption Application Form - Gateshead Council,united Kingdom Page 2