Paying benefit
to your landlord
Benefits, 16 Church Road, Stockton-on-Tees, TS18 1TX
Helpline 01642 393829iMinicom 01642 605569
If you want Housing Benefit payments to go direct to your landlord, fill in your name and
address, sign the form and give it to your landlord to fill in the remainder.
Full name Please print
Your landlord’s declaration
I agree to accept Housing Benefit payments for the tenant named in this form.
I understand if I am considering taking eviction action with my tenant due to rent arrears and there
are outstanding housing benefit issues I can contact you to see if you can help.
I understand that by law:
• I must tell you straight away if I find out about any change in the tenant’s circumstances;
• you can stop paying benefit to me if I do not tell you about any change of circumstances;
• I can be prosecuted if I accept Housing Benefit which I know I am not entitled to; and
• if you pay me too much Housing Benefit for any tenant, I must repay it. You can take the amount
of overpaid benefit from the benefit I get for any other tenants. This will not affect their rent.
Signature Date
Full name Please print
If we do not already have your account details to pay benefit straight into your account
please enter them on the next page.
Payment direct into an account
What name or names is the account in?
Fill in the details of the account you want your money paid into. Payments cannot
be made to Post Office accounts, or Building Society Accounts that require a third
reference number.
Bank or building society cheque account or Bank deposit account not a mortgage account
Name of bank or building society
Sort code
Account number
Type of account - for example, a
deposit or current account
Building Society savings account - not a cheque or mortgage account
Name of building society
Sort code
Account number
Roll number
GIRO account
Account number
National Savings Bank investment account - not an ordinary account
Account number