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Part 1 - Personal Details (continued)

Have you or your partner claimed Housing Benefit or Council Tax Benefit before?

If yes when did you last claim?

Which council did you claim from?

What name did you use for the claim?

What address did you claim for?

Tell us whether you were the homeowner, a private tenant, a council tenant or a lodger at any of
these addresses.

What is your nationality?

Have you come to live in the United Kingdom, the Republic of Ireland, the Channel Islands or the
Isle of Man in the last five years? Yej

If ‘Yes’, when did you arrive?
Do you have leave to remain?
If yes please provide proof

under a sponsorship undertaking?
If ‘Yes’, please tell us about the sponsorship undertaking.

Sponsor’s Title and Forename
Sponsor’s Surname

Sponsor's Address

Home Office reference number
Date of sponsorship

Proof of ID must be provided for you and your partner (if applicable).

HR/PTD 07 SWUOAJO
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