A Claim Form For Housing Benefit And Council Tax Support (Page 19 of 28) in pdf

A Claim Form For Housing Benefit And Council Tax Support Page 19

Part 17b Completion of this form

page 19

If this form has been filled in by someone other than the person claiming, this part must be completed.

Please tell us why you are filling in this form for the person claiming.

After you have read the declaration below, you must sign and date it.

I declare that I have confirmed with the person claiming that the answers I have written on this form are true and complete.

I declare that I have read Changes you must tell us about (Part 14b) and the Declaration (Part 17a) to the person claiming.

I declare that I have confirmed that the person claiming understands Changes you must tell us about (Part 14b) and the Declaration

(Part 17a).

I understand that if I have knowingly written information on this form that is not true or is incomplete, Slough Borough Council may

take action against me. This may include court action.

Signature of the person who filled in the form

Name of the person who filled in the form

Address of the person who filled in the form

Relationship to the person claiming

Date

Part 18

What to do next

You should now have:

• filled in the claim form for Housing Benefit and Council Tax Support

• collected any evidence to support your claim - but remember not to send valuable items, and

Please send your completed claim form to:

Slough Borough Council Benefits Service, PO Box 1032, Slough, Berkshire SL1 3YT

Benefits helpline: 01753 475111

Minicom: 01753 875030

For public reception please go to MyCouncil, Landmark Place, High Street, Slough.

A Claim Form For Housing Benefit And Council Tax Support Page 19