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P. 150

Part 9 - Rent (continued)



              Do you pay any service charges separate from your rent?
              For example, for cleaning or lighting in shared areas, an alarm system,
              gardening, a warden, general counselling or support, or lift maintenance etc.

              If Yes, what for and how much?

                                     Description of charge                             How much? £













             Does your rent include a charge for meals?

             Please tick what meals you and your family members get included in your rent:
                    Breakfast              Breakfast and Evening meals                All meals


              Do you have a main home somewhere else?
              If your main home is somewhere else in the UK or abroad, tick yes
              even if you do not pay rent for it.


             What is the address?










             Do you pay rent for this address?

             If yes, how much?



















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