Deputy Chief Executive’s Department, Council Offices, Foster Avenue, Beeston,
Nottingham, NG9 1AB
Telephone: 0115 9177777 Fax: 0115 9173683
E-Mail: email@example.com Website: www.broxtowe.gov.uk
Account Number: Property Reference:
COUNCIL TAX DISABLED PERSONS - REDUCTION SCHEME APPLICATION FORM
The liable person for the Council Tax may apply for a reduction in their bill if there is a person who has their
ole or main residence at their address and that person is substantially and permanently disabled.
PART 1 - APPLICANT'S DETAILS: (This is the person who will be liable for the Council Tax):
Full Name: Daytime Telephone Number:
PART 2 - DISABLED PERSON'S DETAILS:
PART 3 - PROPERTY DETAILS:
Does the property have a second bathroom required for meeting the needs of the disabled person?
Does the property have a second kitchen required for meeting the needs of the disabled person?
Is it essential for the disabled person to use a wheelchair within their property?
Is there a room in the home which is predominantly used by, and required for meeting the needs
of the disabled person?
If "yes" please give details.
PART 4 - DECLARATION
I confirm that the information given on this form is correct and I will notify you immediately if I believe that I
am no longer eligible for a reduction granted in respect of this application.
Signature of Applicant Date
For office use only: Initials Date
System updated by
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