Housing And Council Tax Benefit Application - South Norfolk Council

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South Norfolk Council
South Norfolk House
Cygnet Court
Long Stratton
Norwich NR15 2XE
Housing and Council Tax Benefit Application
Part 1 –
About you and your household
This is my claim for:
I am a:
Date form issued:
Housing Benefit
Owner Occupier
Council Tax Benefit
Private Tenant
Claim number:
Second Adult Rebate
Housing Association Tenant
Your Name:
Date of Birth:
National Insurance Number:
Address:
Have you lived in
Postcode:
Y / N
Date Moved In:
this area before?
Previous Address:
Email Address:
I would like to receive my benefit notifications and communications by email:
Y / N
Contact No:
Mobile No:
Nationality:
Date moved to UK (If applicable):
Are you a recent care leaver?
Registered blind or Disabled?
Partners Name:
Date of Birth:
National Insurance Number:
Address:
Have you lived in
Postcode:
Y / N
Date Moved In:
this area before?
Previous Address:
Contact No:
Mobile No:
Nationality:
Date moved to UK (If applicable):
1

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