Please read this form carefully and complete all sections.
Lack of proof of ID or an incomplete form will be returned to you.
The information you give us will be used to assess your housing need and prioritise you on
Tamworth Borough Council’s Finding a Home Scheme.
If you think you are homeless or threatened with homelessness, please tick this box.
Please provide proof so that we can prioritise your application. We may contact
you for further information.
Please complete this form and return to us by email: Alternatively you can print it out, complete and
post it back into us at: Tamworth Borough Council, Marmion House, Lichfield Street,
Tamworth, Staffs, B79 7BZ. In order to process the application form we will require you
to email proof of ID as requested and additional documentation listed on Page 2.
If you need help with the form and have nobody to assist you, please contact
Housing Solutions: Tel: 01827 709709 Fax: 01827 709376
You can also visit our website:
Before we can process your application we will need ALL of the proofs that apply to
your circumstances. See the list on section 1 in this form.
Provided we have received all relevant proofs and a completed and signed form, you
should hear back from us within 14 days from the date we received your application. If
your application is accepted, we will send you an application confirmation letter. Please
keep your application confirmation letter. It contains your individual reference number, the
number of bedrooms you are assessed to need and other information you will need in
order to express your interest in properties we advertise on
Change of circumstances
Once your application has been accepted, it is your responsibility to keep it up to
date. You must tell us of any change in your circumstances as it may affect your
application e.g. if you move, or your household changes. The Housing Solutions Team
can provide you with a change of circumstances form (contact details above.) It is
also available on our website
The enclosed Finding a Home Guide will help you to complete this form and gives you
more information on how our choice-based lettings scheme works. Keep it safe, as you may
need to refer to it again.
If you would like this document in another format (such as large print) or
different language, or if you require an interpreter, please contact us on
01827 709709 or email
Tamworth Borough Council
Housing Application Form
Proof of identity: you must provide one of the following documents for every
person on your application, including children
Birth Certificate
if you no longer use your birth name, please supply proof of change
Valid Passport
– see Section 5 if you are subject to immigration control or from the
European Economic Area
Full or provisional driving licence
– we cannot accept counterparts alone
Proof of current address: All adults on your application, whether or not they
currently live with you, must provide one of the following:
Current tenancy agreement Council tax bill
Utility bill
– gas ,electricity, water, telephone
DWP benefit document
Full or provisional driving licence
Proof of rent account on current property
If you are currently renting, you must provide one of the following:
Rent statement/book
Bank statements showing rent payment to your landlord for the last three months
Reference from your current landlord
Proof that your children live with you, or will be a part of your household
when you move. You must provide one of the following:
Letter from Child Benefit Agency
- confirming payment for children at your current address
A recent bank statement showing Child Benefit payments
Proof of pregnancy
Your maternity record from the hospital confirming your Estimated Due Date
Your pregnancy will only be recognised in your bedroom entitlement after 20 weeks gestation.
Proof of National Insurance Number
Wage slip, DWP letter, or National Insurance card or benefits letter
1. Documents and proofs we need to register your application
Please supply the following documents. We can only accept copies, not originals. If you
bring originals in, we can copy them in reception but you must wait for them before you
leave as Tamworth Borough Council is not responsible for any originals. If you fail to
supply the relevant information it will delay your application.
Please tick the documents you have provided.
Proof of benefits
Copies of your most recent benefits award letters
, including any disability-related benefit
Proof of income
Your wage slips or 2 months’ bank statements
Proof of local connection.
Applicants must have a local connection and housing need. Without proof of local
connection they would have a reduced banding applied. Please indicate your local
connection and provide proof of one of the following:
Have been resident within the borough of Tamworth in settled accommodation
continuously for the last 2 years and continue to
Have permanent employment or be self-employed within the Borough of Tamworth for a
continuous period of at least 12 months for more than 16 hours per week. Where working
hours fluctuate i.e. casual or zero hour’s contract, an average will be taken over 12 months
Close family with an additional health/welfare need - Where there has been frequent
contact and dependency and:
The applicant has a close relative* who has been living in the borough of Tamworth
continuously for the last 5 years and
Where the relative has health or care needs which require the support of the household
that is applying to move to be in the area or where a family member needs to move to the
borough of Tamworth to be closer to family who live there from whom they require
*Close family members may be defined as parents, children, siblings, grandparents or
grandchildren including step relatives.
If your connection to Tamworth is because of your own residency,
you must provide proof,
such as dated utility bills, or tenancy agreements that cover the relevant period
If your connection to Tamworth is because you have family connections in the area you
must provide:
Proof of your relative’s residency in Tamworth, for example, a copy of a recent utility bill or
bank statement, or a tenancy agreement
A copy of their full/long birth certificate to prove your relative’s identification and proof of
the relationship
Evidence of the welfare, care or support needs
If you work in Tamworth you must provide:
A letter from your employer detailing your job, type of employment contract (permanent,
fixed term or casual, full or part time) and confirmation that you are still employed by them
or a dated contract of employment with your name on, together with your latest
wage/salary slip
If you have a special reason you must provide:
A letter detailing what that reason is from the relevant agency or department, for example, a
letter from the hospital explaining what your specialist treatment is, how long it is likely to last
and why you need to live in Tamworth
Armed Forces
Armed Forces Discharge Note
- where the applicant is currently in or recently left the
Armed Forces, or is the surviving spouse or civil partner of Armed Forces personnel,
and is required to leave Forces accommodation
Persons from abroad, or recently returned to the UK
Applicants accepted as a refugee or granted Indefinite, Exceptional, Discretionary or
Limited leave to remain in the UK, must provide Home Office documentation
Nationals of the EEA must provide proof of current employment or self-employment
Nationals of the EEA must provide proof of settled/pre-settled status
If you are a UK citizen but have recently returned from abroad, please provide proof
that you are habitually resident in the UK
Main Applicant Joint Applicant
Please state the joint applicant’s
relationship to the main applicant
(eg, spouse/partner)
(Mr / Mrs / Miss / Ms / other)
First names
Previous surname(s), or other names
you have used
(male / female / transgender)
Date of birth
National Insurance Number
Marital status
Home phone number
Mobile phone number
Email address
Do you need written
correspondence to be in large print?
Can you speak English?
Can you read English?
If no, which language do you prefer?
In some instances we may email you.
If this is an issue, please state
preferred correspondence method
(state – email, post, telephone, text,
home visit etc.).
Yes / No Yes / No
Yes / No Yes / No
Yes / No Yes / No
2. Personal Details – applicant/s
Application Reference
Input Date:
3. Your Current Address
18. Please give the details of your current address/es
Main Applicant Joint Applicant
Address including postcode
Date that you moved in
/ / / /
19. Please state the number of bedrooms in your curent home:
Main Applicant
Single Double
bedrooms bedrooms
Joint Applicant
(if not living with main applicant)
Single Double
bedrooms bedrooms
Flat – ground floor
Flat – upper floor
Maisonette – ground floor
Maisonette – upper floor
Bed sit / room
Caravan/mobile home
20. Please state your current tenure:
Main Joint Tenure type
Applicant Applicant
Council tenant
Housing Association/Co-op tenant
Tenant of private landlord
Tied accommodation
Staying with friends/family
In supported accommodation
In homeless accommodation
Other, please state:
21. Is your current home in need of major repair?
For example, it’s not wind or water tight or it’s unsafe.
Yes No
22. Do you have the following facilities at your current property.
No piped water supply
Hot water to kitchen
Hot water to bathroom
Inside toilet
Bath or shower
Cooking facilities
23. What type of heating do you have at your current property. Tick one box only.
Full central heating
Fixed heating in some but not all rooms
No fixed heating (portable heaters only)
24. If you are renting, who is your landlord?
Main Applicant Joint Applicant
(if not living with main applicant)
Tamworth Borough Council
Another local authority
– state which one
Private landlord
- provide name and address
Tied accommodation -
- provide name and address
of your employer
Housing Association
– provide name
4. Reasons for applying
25. Please tell us why you are applying for housing. Tick all boxes that apply.
Notice to quit
Current property too big
To be near to family
Current property too small
Need sheltered housing
Release from prison
Hospital discharge
Employed in Tamworth
Other – please state:
Rent too expensive
Domestic abuse
Mortgage arrears
Relocating to Tamworth
Relationship breakdown
Disrepair of current property
Armed forces discharge
Homeless or threatened with
Main Applicant Joint Applicant
(if not living with main applicant)
Is there a different address
that you would prefer us to
use to contact you?
Reason for a different
contact address:
5. Alternative address for correspondance
6. Pets
Do you have any pets?
Yes / No
If Yes, please state types and numbers:
Some type of housing is unsuitable for pets, would you be willing
to make alternative arrangements for your pets if necessary?
Yes / No
Housing Associations
- We work in partnership with several housing associations with
properties in Tamworth. Ticking this will ensure you are considered for nominations.
Shared Ownership
- An alternative to renting and full ownership. With shared ownership you
buy a ‘share’ of your home and pay rent on the remainder. It is particularly suitable for
people with a regular income who wish to buy their own home but cannot afford to do so
through conventional methods.
Sheltered Accommodation
- There are several sheltered housing schemes in Tamworth, see
our website for more information:
Incentive to move scheme
- Available to tenants of Tamworth Borough Council wanting to
downsize from a family home to a smaller property. We’ll send you a leaflet on how to apply.
The following options may also be available to you:
Private rented accommodation / Bond scheme
- Please contact Housing Solutions on
01827 709709 for further details/ application form.
Mutual exchanges
- If you are a council or Housing Association tenant and are interested
in a mutual exchange, please go to for more information.
28. Are you interested in any of the following housing options?
Please tick the options that you are interested in.
7. Housing Options
You may wish to complete our housing options assessment tool on our Finding A Home
8. Your Current Household
First Name Last name Gender Date of
to you
To be
with you?
Are they the
tenant or
Yes / No Yes / No
Yes / No Yes / No
Yes / No Yes / No
Yes / No Yes / No
Yes / No Yes / No
Yes / No Yes / No
29. Please list below everyone who lives with you now. Do not include yourself or any
joint applicant. You will need to include proof of ID for anyone who will move with you
30. Please list below anyone else who does not currently live with you but you want
to be housed with you
First Name Last name Gender Date of
to you
Are they the
tenant or
Yes / No
Yes / No
Yes / No
Yes No
31. Are you or anyone who will move with you pregnant?
If yes, please state name of pregnant applicant:
What date is the baby due: / /
It is important that you confirm the type of benefits you are receiving. Please provide a copy
of your Benefit Award Letter(s).
Main Applicant Joint Applicant
£ Start date £ Start date
JSA or Income Support
£ £
Working Tax Credit
£ £
£ £
Pension Credit
£ £
Child Benefit
£ £
Disability Living Allowance/PiP
£ £
Universal credit
£ £
Carer’s Allowance
£ £
Employment & Support Allowance
£ £
Personal pension
£ £
(please state:) £ £
32. Do you receive any of the following?
Please state W (weekly) or M (Monthly) in the box next to the start date.
9. Employment, Benefits and Savings
Main Applicant Joint Applicant
Yes / No Yes / No
If Yes, who is your employer?
And what was your start date?
Yes / No Yes / No
Yes / No Yes / No
In full time education
Yes / No Yes / No
Yes / No Yes / No
33. What is your current employment status?
34. If employed, please state your annual income before tax:
Main Applicant Joint Applicant
What is your annual income before tax?
£ £
Do you receive any other income?
Yes / No Yes / No
If Yes, what is that income?
e.g. child support, shares/dividends
And amount received per month?
£ £
It is important that you provide proof of your income by providing 2 month’s proof of income
10. Disability or Ill Health
35. Do you, or does anyone moving with you, suffer from any life-limiting illnesses,
health problems or disabilities?
Yes No
If Yes, please write the name of the person affected in the relevant box below:
36. Is your home worsening a medical condition and/or disability of you or
anyone else included in this application?
Yes No
37. Would the medical condition and/or disability be improved if you or they
moved to a more suitable home?
Yes No
38. If you have any disability or problems that might affect the type of property
you need to live in, please give details:
Type of disability Persons affected
Hearing impairment
Mental health problem
Visual impairment
Learning disability
Mobility impairment
(difficulty getting around)
(please state)
If yes, please give details:
If yes, please give details:
If yes, the council will require evidence to support this and any letters from medical
professionals should be included to support this.
Main Applicant Joint Applicant
Address 1
From: To: From: To:
Tenure type eg living
with family, private
rent, homeowner etc.
Landlord’s name and
address if rented
Reason for leaving
Address 2
From: To: From: To:
Lived there as
Landlord’s name and
address if rented
Reason for leaving
Address 3
From: To: From: To:
Lived there as
Landlord’s name and
address if rented
Reason for leaving
Address 4
From: To: From: To:
Lived there as
Landlord’s name and
address if rented
Reason for leaving
11. Your previous addresses
39. Please provide addresses for the last five years
You must provide information and addresses of former landlords.
Start with your most recent previous address and go back.
40. If you or anyone else included in this application has ever previously been a
tenant of Tamworth Borough Council, please give the details
/ / / /
42. If you or anyone else included in this application has ever been evicted from a
Council or Housing Association property, a privately rented property or supported
accommodation, please give the details
Name of person evicted
Address of property
Dates at the property
Landlord details
Reason for eviction
41. Have you have already received an incentive to move payment from
Tamworth Borough Council?
If Yes, please provide details of the address you moved out of, and the
Yes No
Tamworth Borough Council may make further enquiries regarding this.
43. Do you, or anyone moving with you, own property in this country or abroad?
In this country:
Yes No
Yes No
44. If anyone to be rehoused is a tenant or homeowner, please give details:
Person’s name
Are they a tenant?
Yes / No
If Yes, who is the landlord?
Please provide a contact
number for private landlords.
Will they give up the tenancy?
Yes / No
Are they a homeowner?
Yes / No
If Yes, what is the value of the
What mortgage is
What is the equity?
(the amount of
money left after the mortgage is paid off)
Who is the mortgage lender?
Will the homeowner sell the
Yes / No
12. Your Current Circumstances
Main Applicant Joint Applicant
Do you think you are homeless or threatened
with homelessness?
Yes / No Yes / No
Please tell us why you cannot stay in your current accommodation and provide the date you
need to leave by:
Are you currently sharing a bathroom or kitchen
with people who are not in your household, and
are not otherwise related to you?
Yes / No Yes / No
Are you a young person currently or recently in
the care of the local authority?
Yes / No Yes / No
Please give the date you will require housing and details of your support worker/s:
Are you in hospital?
Yes / No Yes / No
If Yes, please state which hospital and your expected date of discharge:
Are you in prison?
Yes / No Yes / No
Provide confirmation of your expected release date:
Type of saving Main Applicant Joint Applicant
£ £
£ £
£ £
45. Please detail the value of ALL Savings, Shares, and Equity in Property
and Land that you own:
It is important that you provide proof of all savings and/or assets.
Main Applicant Joint Applicant
Are you at risk of physical, mental or sexual
abuse from someone in your household if you
stay in your current home?
Yes / No Yes / No
If Yes, please give details:
Are you or member of your household suffering
from harassment, violence or other antisocial
Yes / No Yes / No
If Yes, please give details:
If you answered Yes to the above question, we will need confirmation of this from the Police or
another official source, such as a Solicit
or or a Social Worker.
Do you need to move to live nearer relatives to
provide or receive support?
Yes / No Yes / No
If Yes, please give details such as
including postcode:
Relationship to you:
Phone number:
Details of support:
Armed Forces:
Are you serving in the British
Armed Forces and planning to leave soon, or
have you left within the last six months?
Yes / No Yes / No
Are you in Armed Forces accommodation but
ed to leave?
Yes / No Yes / No
Are you suffering from a serious injury, illness or
disability that is attributable wholly or partly to your
service? Or ar
e you the spouse or civil partner of
someone whose death is attributable, wholly or
partly, to their service in the armed forces?
Yes / No Yes / No
Please provide your notice of discharge from the Forces and a letter stating you are
required to leave Forces accommodation. If you have answered ‘Yes’ to the third question
, disability, injury or death as a result of service), please provide written evidence.
We cannot include certain people who are ‘persons from abroad’ on our housing register.
Please answer the following questions and provide supporting documentation (see section
If you are unsure about your eligibility, you should complete the application. We may contact
you for more information before we can let you know if you are eligible.
55. Please indicate which of the following applies to you and to any joint applicant
13. Eligibility to join the register including immigration status
Main Applicant Joint Applicant
Are you a British citizen, or a Commonwealth citizen
with a right of abode in the UK?
Yes / No Yes / No
Are you subject to any immigration controls?
Yes / No Yes / No
If Yes, please tell us whether any of the following statements apply to you.
You will need to provide us with copies of your Home Office documents.
Granted refugee status
Yes / No Yes / No
Granted exceptional leave to remain with no
restrictions on recourse to public funds
Yes / No Yes / No
Granted indefinite leave to remain (you will also need
to prove that you are habitually resident in the UK)
Yes / No Yes / No
Humanitarian protection granted under immigration
Yes / No Yes / No
Limited leave to remain in the UK
– give the expiry date
Yes / No Yes / No
Other – please state
If No, are you an EEA national?
If Yes, state which country.
Yes / No Yes / No
If you are an EEA national, please answer the following questions.
You must provide proofs of your eligibility to apply for housing.
Do you have settled or pre-settled status?
Yes / No Yes / No
Are you currently employed, or self-employed?
Yes / No Yes / No
If you are from Croatia, are you working under the
authorisation scheme?
Yes / No Yes / No
If you are an EEA national and not currently working:
What date did you enter the UK?
Have you lived in the UK continuously since that date?
Yes / No Yes / No
Tell us why you are not working now
Is anyone else on your application subject to immigration control?
Yes / No
Which person and what is their immigration status?
You must provide proofs.
14. Other support
Main Applicant Joint Applicant
Social Services
If yes, please provide
Yes / No Yes / No
If yes, please provide
Yes / No Yes / No
Any other Support Provider
If yes, please provide
Yes / No Yes / No
56. Do you receive support from any of the following?
We need to make sure that everyone is treated fairly regardless of any connection with the
16. Connection with the Council
Are you or any member of your household an employee of
Tamworth Borough Council, or related to an employee of
Tamworth Borough Council?
Yes / No
If Yes, please state their name and their relationship to you:
Are you or any member of your household a Tamworth Borough
Councillor, or related to a Tamworth Borough Councillor?
Yes / No
If Yes, please state their name and their relationship to you:
This would give authorisation to discuss your application with the person named below:
Your representative’s name
What is their relationship to you?
Do they hold Power of Attorney for you?
If yes, they must provide us with a
copy of the Power of Attorney
Yes / No
Which organisation do they work for
? This is only relevant if they
are representing you as part of their
working role.
Their contact address
Their day time phone number/s
Their email address
Signature of your representative
I/we give Tamworth Borough Council authorisation to discuss my housing application with the
representative named above
Signature of the applicant
Signature of the joint applicant
15. Authority to release
17. Equality and Diversity
Asian or Asian British
Other Asian,
please state:
Mixed Heritage
White and Asian
White and Black African
White and Black Caribbean
Other Mixed,
please state:
Prefer not to say
Black or Black British
Black Caribbean
Black African
Other Black,
please state:
Other White,
please state:
Chinese or other ethnic group
Other mixed,
please state:
69. Please tick the appropriate box of how would you describe your ethnic origin?
Main Joint Ethnic Origin Main Joint Ethnic Origin
Applicant Applicant Applicant Applicant
Tamworth Borough Council is committed to ensuring equality and diversity throughout its services.
We ask for the following information to help us ensure that all applicants are treated fairly and
that everyone receives a service that takes account of their needs. You do not have to answer
these questions - it will not affect your application or priority and we will still provide you
with a fair service.
70. Do you consider yourself to have a disability? By disability we mean a condition
which has a long term and substantial effect on your ability to carry out day to day activities.
Main Applicant Joint Applicant
Do you consider yourself to
have a disability?
Yes / No Yes / No
72. How would you describe your religion?
Main Joint Religion Main Joint Religion
Applicant Applicant Applicant Applicant
Christian, including C of E Hindu
Muslim Buddhist
Jewish Sikh
Other - please state:
No religion
Prefer not to say
71. How would you describe your nationality?
Main Joint Nationality
Applicant Applicant
UK national – resident in the UK
UK national – returning to the UK
Non-UK National from overseas – please state:
Other European Economic Area country – please state:
Other nationality – please state:
Prefer not to say
73. How would you describe your sexual orientation?
Main Joint Sexual orientation Main Joint
Applicant Applicant Applicant Applicant
Prefer not to say
18. Additional Information
Main Applicant
Have you ever lost accommodation due to rent arrears?
Yes / No
If Yes, please give details:
Has anyone ever evicted you or anyone on your application
for antisocial behaviour within the last five years?
Yes / No
If Yes, please give details including the name of who was evicted and the landlord who
Has anyone on this application ever received an Anti-Social
Behaviour Order(ASBO) or community protection notices or
Yes / No
If Yes, please give details:
Are you or anyone on your application required to register
with the Police under the terms of the Sexual Offences Act
Yes / No
Do you have any unspent convictions?
Yes / No
If Yes, please give details:
Please check and sign your completed application overleaf before
returning it.
Designed and produced by
Tamworth Borough Council.
Marmion House, Lichfield Street, Tamworth, Staffordshire, B79 7BZ
Tel: 01827 709709
This section is important. Please use it to tell us about your current circumstances, and why you
need to move.
19. Declaration and signature/s
This must be signed before submitting your application.
Please note:
Housing fraud
- It is a criminal offence to knowingly provide a false statement or withhold
information to assist you in obtaining accommodation from Tamworth Borough Council or a
housing association or private housing provider nominated by us. We will take legal action
against anyone found committing an offence and may also seek possession of any
property obtained.
- Tamworth Borough Council is the Data Controller for all personal data
collected in this application. We collect your personal information under Legal Obligation to
allow us to provide administration for your application. We may share your personal
information with third-parties where required to by law or where it is necessary to process
your application. Full details for types of personal information we collect, purpose we collect
it, third-parties we share it with, third-party services providers and how we maintain the
security of your information can be found in our Fair Processing Notice - a hard copy is available upon request. Please ensure
you read our fair processing notice before submitting your personal information to us.
Information you give us will be kept for no longer than necessary. Our Retention Schedule
can be found at
Please read this declaration carefully before you sign and date it. If you are making a
joint application, both applicants must sign. Once you sign and date this form it
becomes a legally binding document. If there is any part of the declaration you do not
understand, it is your responsibility to find someone to explain it to you. Tamworth
Borough Council’s customer service centre has trained staff who can explain anything
you do not understand.
To the best of my knowledge and belief the information that has been provided on this form is
true, complete and correct.
I will immediately declare any changes in this information.
I understand that if I give false or misleading information or I omit information for the purpose of
obtaining housing, it may be regarded as a criminal offence and action could be taken against
me, including refusal of my application, court action and recovery of property.
I understand that the information I have provided will be used to help determine my eligibility for
housing, and that any information given by me relating to this housing application, or given with
my consent by others, will be placed on Tamworth Borough Council’s housing register. Where other
people’s personal information is given on the form, I confirm that they have consented to its use.
I give permission for you to contact individuals or agencies referred to by me on this form, when
necessary, and also other individuals and agencies in order to process my application.
Applicant's signature Date
Joint applicant's signature Date
/ /
/ /
Please note: We cannot
accept the form without:
- Your signature and date
- The signature and date of
any joint applicant
- ID for everyone on the
- All relevant proofs requested
in section 1, and ticked
(06/20) 1821