BRCC-Discretionary Housing Payments and Council Tax Support Exceptional Hardship Fund

Discretionary Housing Payments and Council Tax Support Exceptional Hardship Fund

This online application form is for both Discretionary Housing Payments and Council Tax Support Exceptional Hardship Fund payments – as we require very similar information to process these applications we have made it easier for you to apply on one form.

The two funds are administered separately using different regulations and policies which may mean that you are awarded payment from one fund but not both.

Discretionary Housing Payments

Discretionary Housing Payments are payments awarded at the discretion of Hyndburn Borough Council if you need short term help towards your rent to support you while you find cheaper housing, re-organise your budget or they may be awarded for help with payments for deposits, rent in advance or removal fees. They are not payments of benefit but you must be in receipt of Housing Benefit from Hyndburn Borough Council or the Housing Costs element of Universal Credit to be considered.

If you are moving into Hyndburn from another borough and wish to apply for help with a rent in advance, deposit or bond, please apply to your current Council.

If you are applying for rent in advance, a deposit or bond because you are homeless or you are at risk of becoming homeless, please contact our Housing Advice Team on 01254 388 111 as you may qualify for help under the Council’s rent deposit scheme.

Council Tax Support Exceptional Hardship Fund

The Council Tax Support Exceptional Hardship Fund has been set up by the Council to assist recipients of Council Tax Support who are facing exceptional financial hardship. The fund has been created to provide further financial assistance where an applicant is in receipt of Council Tax Support and is suffering exceptional hardship. If you are not in receipt of Council Tax Support you will not qualify.

Please upload all proofs during the claim process to avoid any delays caused by information having to be requested from you.

Section 2: about your current circumstances

To help us make a decision we need information about your current financial circumstances and what in particular has caused you hardship. For each answer, if you have any documents to support the information you have provided, please provide it with this form. Originals will be returned to you. Please answer each question with as much detail as you can.

What is the address that the request for help is for?(Required)

Street Address Address Line 2 Town / Postcode

How much is the rental deposit/rent in advance?(Required)

And what period does this cover?

Please upload evidence of deposits or rent in advance.

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB, Max. files: 4.

If you are applying for help with rent in advance, a deposit or bond, have you contacted our Housing Advice Team about the Rent Deposit Scheme?(Required)

Yes

No

What was the outcome please?(Required)

Who is the landlord of the property?(Required)

How much are the removal fees?(Required)

Please upload evidence of the removal fees.

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB, Max. files: 4.

Is the property undergoing any major structural renovations?(Required)

Yes

No

Is the property occupied?(Required)

By yourself

By someone else

No

Please provide the occupant’s details:(Required)

Please outline other current debts and how you are meeting these payments. Please specify if any debts are subject to any court orders. If there aren’t any please put none as your answer.(Required)

Please outline how you are paying for utilities and food.(Required)

Has there been a death in the household in the last 12 months?(Required)

Yes

No

Do you have any savings or property here or abroad?(Required)

Yes

No

Please provide evidence – e.g. banks statements

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB, Max. files: 4.

Are you receiving financial support from any other fund or have you applied to any other hardship funds?(Required)

Yes

No

Please tell us which fund:(Required)

What are the current circumstances which are causing you hardship?(Required)

How long do you expect these circumstances to continue?(Required)

What have you done to improve this situation?(Required)

Please provide any additional information you think will support your claim.

Section 3: statement of income and expenditure

Does anyone live with you?(Required)

Yes

No

Please provide details of all people living with you:(Required)

Please click on (+) button to add more members

Name

Date of Birth

Relationship to you

Detail of all incomes:(Required)

Please provide details of all income for you and your partner if you have one:

Please click on (+) button to add more entries

Type of income

You: (£ per week)

Your partner: (£ per week)

Please upload proof of all income listed above

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB, Max. files: 10.

Detail of all expenditures(Required)

Please provide details of all expenditure for you and your partner combined if you have one:

Please click on (+) button to add more entries

Type of expenditure

Amount per week

Detail of any other expenditures not covered above:

Please provide details of all expenditure for you and your partner combined if you have one:

Please click on (+) button to add more entries

Type of Expenditure

Amount per week

Total expenditure (per week):(Required)

Section 4: Payment

If you qualify for help with your council tax any entitlement that you may have will only be paid directly to your Council tax account.

If you qualify for a Discretionary Housing Payment for help with your rent this will only be paid by BACS either to yourself or your landlord.

Do you want any payment to help with your rent to be paid to your landlord?(Required)

Yes

No

If you qualify for any other help for your housing costs e.g. for removal fees this will only be paid directly to you by BACS.

Please provide the account details for any BACS payment.

Name of the Account Holder(Required)

Sort Code(Required)

Account Number(Required)

Section 5: Declaration

I declare that the information I have given on this form is true and correct. I understand that I may be prosecuted if I try to get a Discretionary Housing Payment and/or Council Tax Support Exceptional Hardship Payment dishonestly. I authorise Hyndburn Borough Council to make enquiries necessary to verify the details I have given on this form.

How would you like to present your signature?(Required)

Sign electronically

Upload my signature as a file

Signature(Required)
A signature can be added in this box by using a mouse for a PC or by using a finger or suitable pen on a touch screen OR an electronic signature should be uploaded as a file below .

Signature Upload(Required)
Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.

Hidden

Date
DD slash MM slash YYYY

Section 4a: Declaration to be signed if you have completed this form on behalf of someone else:

I declare that the information I have given on this form is true and correct. I understand that I may be prosecuted if I try to get a Discretionary Housing Payment and/or Council Tax Support Exceptional Hardship Payment dishonestly on behalf of the person named in Section 1 as the applicant.

I confirm that I have been given permission by the applicant to complete this form on their behalf. I confirm that I understand that I may not be entitled to any information about this applicant or this application as a result of completing this form. I authorise Hyndburn Borough Council to make enquiries necessary to verify the details I have given on this form.

How would you like to present your signature?(Required)

Sign electronically

Upload my signature as a file

Signature(Required)
A signature can be added in the box above using a mouse for a PC or by using a finger or suitable pen on a touch screen OR an electronic signature should be uploaded as a file below .

Signature Upload(Required)
Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.

Hidden

Date
DD slash MM slash YYYY

BRCC-Discretionary Housing Payments and Council Tax Support Exceptional Hardship Fund