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Housing Benefit and Council Tax Support change of circumstances
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Please note you WILL NOT be able to submit this form without evidence of the change in your circumstances. You must include your claims reference or your full name and full address for identification.
First name (required)
Surname (required)
Date of birth (dd/mm/yyyy)
National Insurance number
Contact phone number, preferably a mobile number so we can text you
Email address (required)
Address you are claiming at, including postcode (required)
Claim reference number
What date did the change happen (dd/mm/yyyy)
What is the change you want to tell us about - required
Starting work
Finishing work
Change in benefits
Someone has moved in
Someone has moved out
Change in income
Someone who lives with me has had income change
Rent has changed
Savings have changed
Increase in wages
Tell us about the change
Please provide a contract of employment, showing the hours of work and the rate of pay, or provide your first wage slip.
Please provide your last wage slip or P45 Please tell us what your income will be now you are not working.
Please provide details of change and the new award letter
Please provide the name, date of birth, National Insurance number and nationality of the person who has moved in. Tell us what relation they are to you and provide proof of their income.
Please provide their forwarding address
Please provide evidence of change, wage slips, award letters etc.
Please provide details of change and proof of change, i.e. award letters and wage slips
Please provide a letter from the landlord confirming new amount and date of change
Please provide a bank statement, share certificates, premium bonds
Please provide evidence of the increase, eg wage slips
Before you send your evidence please read the following statement carefully.
I understand the following: It is a criminal offence to provide incorrect information and or fail to declare a change in my circumstances which I am required to report immediately. I know I must let the Council know immediately about any changes in my circumstances which might affect my claim. Examples of relevant changes in circumstances are: If your income goes up or down, if your capital goes up or down, if you or your partner start working or change jobs, if anyone leaves or joins your household or their income changes.
Please provide any supporting documents (Microsoft Word / Adobe PDF format) or images (JPG / PNG etc)
The Council may check the information provided on this form and obtain further, relevant information to enable them to process my claim for Housing and or Council Tax Support.
By submitting this form you are declaring that all the information you have given is correct and complete.
I agree