The Forum Moat Lane Towcester Northants
NN12 6AD Tel: 01327 322322
Fax: 01327 322074 DX: 16938
Minicom: 01327 322275 – (access for deaf &
partially hearing people)
Dwelling Left Empty by a Bankrupt
Please complete this form in respect of the person who you consider should be
disregarded for Council Tax. Please return the form to the Customer Service Centre.
The form should be completed in BLACK INK and in capitals where appropriate.
Part 1 – Details of the property to be exempt
Property Address
What date did the property become unoccupied
Part 2 – Details about who was in occupation of the property
Please provide full names and tick to confirm who has become bankrupt
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Forwarding address
Part 3 – Verification
Please provide supporting documentation (please detail enclosures below)
Part 4 – Declaration
I declare that the information stated above is true and correct to the best of my
knowledge and belief. I shall advise the Customer Service Centre if the
circumstances change. I understand that making a false declaration may render me
liable for prosecution. I authorise the council to make such enquires as it thinks fit to
determine this application.
Print Name Date:
Contact telephone no.
Mobile No.
email address
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The Council will grant exemption from Council Tax indefinitely where the person who would
be liable for Council Tax in respect of an unoccupied dwelling is a trustee in bankruptcy in
accordance with the Bankruptcy Act 1914 or Insolvency Act 1986.
Please note: The property may be furnished.
We will use the information you give in this form, and in any supporting evidence you send
us, to process your application.
We may check information you have provided, or information about you that someone else
has provided, with other information we hold. We may also get information about you from
certain third parties, or give them information, to:
Make sure the information is accurate;
Prevent or detect crime, and;
Protect public funds.
We will not give information about you to anyone else, or use information about you for other
purposes, unless required by law or in order to prevent fraud and error.
The Council is the data controller for the purposes of the Data Protection Act. If you want to
know more about what information we have about you, or the way we use it, please ask us.
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