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Class E - moved to a care home or hospital to receive care

Application form

Uploading evidence

Please take a photo of your evidence, save the photograph to your device beforehand and please keep to a maximum of 12 megabytes.

Privacy Notice

We collect, hold and process information supplied by you in accordance with the Data Protection Act, to allow us to provide services effectively.

Our Privacy Notice is available here

Please complete and submit
Please note: if you answer no to this question because the care placement is temporary, you will NOT qualify for an exemption
If the property will be occupied by anyone over the age of 18, please provide details below


I declare that the information given above is to the best of my knowledge, true and accurate and the Council may verify this from the appropriate sources. I undertake to notify the council as soon as these circumstances change, and I acknowledge that failure to do so could result in a penalty being imposed. I understand that the information given on this form may be matched against data held by other departments and local authorities.