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Full Name                     Date of Birth    Relationship to you





                                                 y
                                            y"


                     If you are an Owner Occupier, a Council Tenant, A Council Boarder or a Rent Free
                     Tenant, you do not need to complete any more of this form. Please sign and date the
                     declaration at the end of the form - Go to Part 4.


                     If you are a tenant of a Housing Association please  also provide your tenancy
                     agreement. You do not need to complete any more of this form. Please sign and date
                     the declaration at the end of the form - Go to Part 4.

                     If you are a tenant of a Private Landlord, please provide your tenancy agreement,
                     answer the questions in Part 3 and then sign the declaration at the end of the form.

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