Housing Payment Application Form

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About you

To assess your Housing Payment application we will need you to upload the following evidence in Section 4 of the form.

If you receive Universal Credit, a full breakdown of your UC award
Proof of your rent i.e your tenancy agreement or rent statement

The maximum total file size for uploads is 20MB.

If you do not have your evidence available to upload, or if the combined size of your files exceeds 20MB, you can send it later using our evidence upload page.

After you have submitted your form, you may need you to provide further information e.g., bank statements to support your application. We will contact you to ask for this if we need to.

First Name: *

Surname: *

Date of Birth: *

National Insurance Number (NINO):

Benefit claim number:

Email:

Phone Number:

Address: *

Postcode: *

Tenancy Start Date:

When did you move into your current address? (If different from the tenancy start date)

Completing the form for someone else

Are you completing this form on behalf of someone else?

Yes - I am completing this form on behalf of someone else
No - I am completing this form for myself

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