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Part 10 - Back dating Part 12 - How you want to be paid

How my benefit will be paid
Housing Benefit and Council Tax Support usually start from the Monday after we receive your claim
form. But we may be able to pay your benefit from an earlier date of your claim if there is a If you are a Council tenant, we will pay any housing benefit you are entitled to straight into your
continuous good reason/s why you did not claim earlier. Telling us that you did not know that you rent account. If you own your property or are awarded council tax support, we will credit this to
were entitled to benefit will not usually be a good enough reason for backdating. your council tax account.

Do you want to claim backdated benefit? If you pay rent to a Housing Association, we normally make payment direct to your landlord - go to
Part 13.
If 'Yes', what date do you want the claim to go back to? For tenants of private landlords, payment will normally only be made directly to claimants, not
landlords. However, under certain safeguards we may pay your landlord direct, for example:

You must explain and supply proof of why you did not claim earlier, and show us proof of your • if you cannot deal with your own financial affairs and/or
income for the period you want to claim for. • if you have negotiated a lower rent with your landlord that someone on Housing Benefit can
Reason for requesting backdating reasonably afford.
To pay your benefit award direct to your landlord, please provide their name and address:

Address:

Private Tenants Only

Payment will be made into your own bank or building society
Please complete the appropriate section below to confirm your bank or building society details.
Part 11 - Anything else we need to know? Name of Bank or Building Society

What name(s) is the account in?
Anything else you think we need to know about to assess your claim properly (not Post-Office accounts)
(please continue on a separate sheet of paper if necessary)
Account Number

Sort Code

Roll Number (if applicable)

HB/CTB 07 04/2013
SFJUWV)
60