Application*for*Reduction*in*Council*Tax*–*Carers*
You$should$complete$this$form$if$you$provide$care$to$someone$aged$over$18$other$than$your$
partner,$who$lives$with$you$and$you$care$for$them$for$at$least$35$hours$per$week.$They$must$be$
entitled$to$one$of$the$Benefits$below$–$$
Please*save*the*document*to*your*device*before*completion.**You*can*then*return*the*Form*as*
an*attachment.$
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Council$Tax$Account$number$
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Address$of$Property$
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Number$of$occupiers$over$18$
living$at$the$property$
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Name$of$person$providing$
Care$
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Name$of$person$receiving$
Care$
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Their$Date$of$Birth$
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Number$of$hours$per$week$
when$care$is$provided$for$this$
person$
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Relationship$to$the$person$
receiving$care$
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Is$the$person$receiving$care$
entitled$to$any$of$the$$
Benefits$listed$below?$
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The*daily*living*component*
of*Personal*Independence*
Payments*at*either*rate$
Yes$ No$
Date$Started$
The*care*component*of*
Disability*Living*Allowance*
at*the*lower*or*higher*rate$
Yes$ No$
Date$started$
Attendance*Allowance*at*the*
lower*or*higher*rate*
$$$
Yes$ No$
Date$started$
An*increase*in*the*rate*of*
their*Disablement*Pension*
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Yes$ No$
Date$started$
An*increase*in*the*Constant*
Attendance*Allowance*
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Yes$ No$
Date$started$
Date$Care$was$first$provided$$
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Has$the$person$you$are$
caring$for$also$applied$for$a$
Council$Tax$disregard?$$
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Declaration*
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I$confirm$that$the$
information$is$correct$to$the$
best$of$my$knowledge.$$
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Name$
Date$
Phone$number$
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Email$address$
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