Devon Home Choice Application Form Devon Home Choice Application Form
31. Please mark with an ‘X’ the box that best describes the religion or belief
Main Applicant Joint Applicant
Other (please specify below) Other (please specify below)
Prefer not to say Prefer not to say
Please complete Section 12.
Section 12: Declaration
(Everyone must complete this section)
I/We understand that if I/we have not provided all the
information required that my/our application will not
I/We conrm that the details given on this application
form are correct. I/We conrm that if any false
information has been given, this application may be
refused, and any offers made may be withdrawn, and
any tenancies granted may be forfeited.
I/We acknowledge that it is a criminal offence to
make a false statement, or deliberately withhold
information in order to seek a tenancy through Devon
I/We understand that members of Devon Home
Choice may prosecute if an offence is committed.
This could lead to a ne of up to £5,000 or
imprisonment, and may also lead to legal action
for the possession of any accommodation found to
have been obtained by deliberately allowing false
information to be used.
I/We undertake to notify Devon Home Choice of any
future change in our circumstances.
I/We also agree that:
• Members of Devon Home Choice are, as part
of the checking process, entitled to visit me/
us at home before entering into any tenancy
• Members of Devon Home Choice have the right
to carry out any necessary enquiries. This entitles
any member of Devon Home Choice to have
access to any information they need in connection
with this housing application. This might include
information about any former tenancies (including
references and rent account balance) or
information about previous criminal convictions.
• As part of my assessment of suitability for a
tenancy, I authorise the Devon and Cornwall
Constabulary to disclose any relevant information
relating to convictions for arson, offences involving
violence, offences of a sexual nature or convictions
for possession, supply or possession with intent
to supply any illegal drugs. It may impact on the
assessment of suitability if authorisation is withheld.
• The personal information that you provide will
be held securely. It will be shared with partner
• To help provide you with a housing service
• To help us assess housing need in Devon,
which may include contacting you as part of
• To inform you about other relevant housing services
• To seek your views
• For our auditing purposes.
• We may check any information you provide
or information we have about you with other
information held by the organisations which
comprise Devon Home Choice.
• Anonymous statistical information may also be
passed to other organisations to assist in the
planning and monitoring of services.
• In addition, the Devon Home Choice service must
cooperate with the prevention and detection of
crime and fraud, which may result in information
about you being passed to others in support of
the National Fraud Initiative.
• If this form is completed on behalf of someone
else, or personal details or contact data about
a third party are provided, then it is your
responsibility to make sure that you have
informed that person of what you have told
Devon Home Choice.
• If you wish to withdraw from a contact list or if
you have any questions about the use of your
personal information please contact the Devon
Home Choice Coordinator (01392 265889). .
Signed Main Applicant
Signed Joint Applicant