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ENFIELD

CHANGE OFADDRESS Council

Part 5:

If you want us to pay your benefit straight to your Landlord or Agent you must sign this declaration.
Please pay my Housing benefit straight to my Landlord or Agent.

I understand that:

• I must always tell you about any change in my circumstances;
• If I do not tell you about any change of circumstances and you pay me too much benefit
because of this, I will have to pay back the extra benefit; and
• I may be prosecuted if I do not tell you about any change of circumstances.

Claimant Signature:

Date:

Now ask your Landlord or Agent to sign this agreement.

Landlord or Agents Name:

I agree to accept Housing Benefit payments for the tenant named on this form. I understand that by
law:

• i must tell you straight away if I find out about any change in the tenants circumstances;
• You can stop paying benefit to me if I do not tell you about any changes of circumstances;
• I can be prosecuted if I accept Housing Benefit which I know I am not entitled to; and
• If you pay me too much Housing Benefit for any tenant, I must repay it. You can take the
amount of overpaid benefit from the benefit I get for any other tenants. This will not affect their
rent.

Landlord or Agents
Signature:

Date:

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