Have you been found by any local authority to have contravened an Approved Code of Practice
under the Housing Act 2004 section 233?*
If Yes, please provide details:
I declare that the information contained in this application is correct to the best of my knowledge.
I understand that I commit an offence if I supply any information to a local housing authority in connection with any of
their functions under any of Parts 1 to 4 of the Housing Act 2004 that is false or misleading and which I know is false or
misleading or I am reckless as to whether it is false or misleading.
I understand that the Council may require to verify my declaration from Criminal Records Bureau information and/or from
other statutory bodies such as the police authority, Fire & Rescue Service, Trading Standards other Councils etc for further
information and confirmation.
THIS FIT & PROPER PERSON DECLARATION FORM SHOULD BE SUBMITTED AS AN ADDITIONAL SUPPORTING
DOCUMENT WITH THE HMO LICENCE APPLICATION
Complete a separate declaration for each licence holder, company or managing agent.
Information on Spent Offences
Under the Housing Act 2004, licence holders and managers of houses in multiple occupation must be fit and proper persons to undertake
the responsibilities of running them.
In order to assist the Council in making proper assessment of your suitability, you are asked to provide details about previous convictions
for criminal offences.
Under the Rehabilitation of Offenders Act 1974, you are not required to provide details about previous convictions which are "spent".
A conviction becomes spent after a certain length of time, which changes depending upon the sentence and your age at the time of
(The periods are halved if the conviction took place when you were aged 17 or less).
Period of good conduct needed
for conviction to be spent
6 months to 2½ years imprisonment
Less than 6 months' imprisonment
A fine or Community Services Order
Probation Order, Conditional Discharge, or Bind Over
An Absolute Discharge
If a person is sentenced to more than 2½ years in prison, his/her conviction can never become "spent".
Any information given will be treated as confidential and used only in connection with this application.
If you have any doubts about whether you have to declare a previous conviction, you should contact your local Probation Office or the
Citizens' Advice Bureau or your Solicitor.