Apply for Discretionary Housing Payment

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By children we mean a child under the age of 20 who you are getting Child Benefit for

Tell us about all income you and your partner receive. Please ensure that this is as accurate as possible so that we can make an informed decision on your current circumstances.

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Click + to add an Income type / Employer name.

Please tell us about any capital, savings or investments you have. If you have a partner you will also need to include any capital, savings or investments they have.

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Please tell us about your (and your partners if you have one) regular household outgoings

Please enter your monthly outgoings
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Click + to add an expenditure type

Debts - Please list any outstanding debts – examples of debts include gas, electricity, water rates, loans, DWP loan repayments, credit union payments, credit/store cards, catalogue payments, hire purchase agreements, Court Orders’


Click + to add repayment amount.

Declaration

I understand the following:

  • You will use the information I have given you to process my application for a Discretionary Housing Payment. You may check the information with other sources within the council, and other councils or government departments.
  • You may use any information I have given you in connection with this and any other claim for social security benefits that I have made or may make. You may give some information to other government organisations or local authority services, if the law allows this.
  • I understand that if I give incorrect or incomplete information or I fail to report any change of circumstances which might affect my benefit, you may take action against me and that this could involve prosecution.

I declare that the information I have given on this form is correct and complete. I will tell you immediately if any circumstances change

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Additional Assistance

 

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