What is your landlord’s full name
and business address?
By landlord we mean the person
or organisation who owns the
property you live in
Phone number
Are you, your partner or any of your or No Yes What is their relationship?
your partner’s children related to your
landlord or agent, or to your landlord’s
partner or the agent’s partner?
Related includes related through marriage,
even if the marriage has ended. Some
examples are ex-wife, ex-husband, aunt,
brother, daughter, father, grandson,
grandmother, son-in-law or stepdaughter.
When did you start renting your home?
When did you move to this address?
If you have not moved in yet, tell us when
you expect to move in. When you move in,
tell us the date you moved in.
What sort of tenancy do you have?
(F
or example, shorthold, assured tied rent
or something like this.)
How long is the tenancy for?
to
What is the property let as? Furnished Barely furnished
Tick the box that applies. Partly furnished Unfurnished
No Yes
How much rent do you pay and how often?
(For example, every week, every two weeks,
every four weeks or every month.)
Has your rent changed in the last 12 months?
When is the next rent increase due?
Send us proof of the date it changed and how much it changed.
Is the landlord or agent’s
3
We must see proof of your rent and tenancy before we can decide how much benefi t you can get.
we can accept as proof of your rent a tenancy agreement or letter from your landlord.
How many rooms are there? In the Just for you and That you share with
whole building your household other people
Living rooms
Bedsit
Bedrooms
Bathrooms or shower rooms
Toilets
Kitchens
Other rooms
/ /
/ /
/ /
/ /
£
every
/ /
