I/We conﬁrm that the information given in this form is correct and to the best of my/our
I/We understand that any information that is untrue or withheld is a criminal offence under
the Housing Act 1996 and may result in my/our prosecution.
I/We understand that this offence may result in my/our application being removed from the
housing register and/or the loss of any tenancy that may have been given to me/us by the
council or a housing association.
I/We undertake to notify the council of any future change in my/our circumstances as
declared on this form.
I/We authorise Tamworth Borough Council to approach other agencies, such as employers,
beneﬁt agency, credit referencing agencies as well as other council departments to conﬁrm
Main applicant Joint applicant
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
If you would like this document in another format (such as large print) or
language, or if you require an interpreter, please contact us on
01827 709709 or email firstname.lastname@example.org