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Our Properties
Your Tenancy
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Manage Your Money
Send Us Feedback
About
Vision, Mission, Objectives and Values
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Our History
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Corporate Information
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Safeguarding
Report Tenancy Fraud
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Test Apply
Step
1
of
11
9%
About you
This application will take around 30-60 minutes to complete, dependent upon the number of applicants/household members. Please ensure you have copies of any required documents, as you will need to attach these in order to submit your application. The documents required are: proof of identity (passport or national ID card, or 2 of the following: driving licence, full birth certificate, recent benefit letter, signed letter from employer), 2 x recent proofs of address (dated within the last 3 months), proof of national insurance number, proof of income for the last 3 months (e.g. payslips, benefit letters), landlord details, tenancy agreements and children’s birth certificates (if applicable). The documents above will be required for every adult on the application.
Hidden
Date
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Title
*
Please select option
Mr
Mrs
Miss
Ms
Dr
First name
*
Middle name
Last name
*
Gender
*
Please select option
Male
Female
Non-binary
Prefer not to answer
Known by any other names?
For example, maiden names or any other legal names.
NI number
*
Date of birth
*
Applicants must be at least 18 years of age (dd/mm/yyyy).
DD slash MM slash YYYY
Mobile number
*
Landline number
Email
*
Are you pregnant?
*
Please select option
Yes
No
Due date
(dd/mm/yyyy)
DD slash MM slash YYYY
Nationality
*
Please select option
Afghan
Albanian
Algerian
American
Andorran
Angolan
Antiguans
Argentinian
Armenian
Australian
Austrian
Azerbaijani
Bahamian
Bahraini
Bangladeshi
Barbadian
Barbudans
Batswana
Belarusian
Belgian
Belizian
Beninese
Bhutanese
Bolivian
Bosnian
Brazilian
British
Bruneian
Bulgarian
Burkinabe
Burmese
Burundian
Cambodian
Camoeroonian
Canadian
Cape Verdean
Central African
Chadian
Chilean
Chinese
Colombian
Comorian
Congolese
Costa Rican
Croatian
Cuban
Cypriot
Czech
Danish
Djibouti
Dominican
Dutch
East Timorese
Ecuadorian
Egyptian
Emirian
Ecuadorian Guinean
Eritrean
Estonian
Ethiopian
Fijian
Filipino
Finnish
French
Gabonese
Gambian
Georgian
German
Ghanian
Greek
Grenadian
Guatemalan
Guinea-Bissauan
Guinean
Guyanese
Haitian
Herzegovinian
Honduran
Hungarian
I-Kiribati
Icelander
Indian
Indonesian
Iranian
Iraqi
Irish
Israeli
Italian
Ivorian
Jamaican
Japanese
Jordinian
Kazakhstani
Kenyan
Kittian and Nevisian
Kuwaiti
Kyrgyz
Laotian
Latvian
Lebonese
Liberian
Libyan
Liechtensteiner
Lithuanian
Luxembourger
Macedonian
Malagasy
Malawian
Malaysian
Maldivan
Malian
Maltese
Marshallese
Mauritian
Mexican
Micronesian
Moldovan
Monacan
Mongolian
Moroccan
Mosotho
Motswana
Mozambican
Namibian
Nauruan
Nepalese
Netherlander
New Zealander
Ni-Vanuatu
Nicaraguan
Nigerian
North Korean
Northern Irish
Norwegian
Omani
Pakistani
Palauan
Panamanian
Papa New Guinean
Paraguayan
Peruvian
Polish
Portugese
Qatari
Romanian
Russian
Rwandan
Saint Lucian
Salvadoran
Samoan
San Marinese
Sao Tomean
Saudi
Scottish
Senegalese
Serbian
Seychellois
Sierra Leonean
Singaporean
Slovakian
Slovenian
Solomon Islander
Somali
South African
South Korean
Spanish
Sri Lankan
Sudanese
Surinamer
Swazi
Swedish
Swiss
Syrian
Taiwanese
Tajik
Tanzanian
Thai
Togolese
Tongan
Trinidadian or Tobagonian
Tunisian
Turkish
Tuvaluan
Ugandan
Ukranian
Uruguayan
Uzbekistani
Venezuelan
Vietnamese
Welsh
Yemenite
Zambian
Zimbabwean
Is there a joint applicant to add to the application?
*
This refers to another adult that will also be named on any tenancy agreements. Details on any additional household members e.g. children will be requested later.
Please select option
Yes
No
Is there anyone else who will be living with you?
*
(Children, friends, other family members etc.)
Please select option
Yes
No
Please select next once complete or if no questions are visible
Joint applicant
Title
*
Please select option
Mr
Mrs
Miss
Ms
Dr
First name
*
Middle name
Last name
*
Gender
*
Please select option
Male
Female
Non-binary
Prefer not to answer
Known by any other names?
For example, maiden names or any other legal names.
NI number
*
Date of birth
*
Applicants must be at least 18 years of age (dd/mm/yyyy).
DD slash MM slash YYYY
Mobile number
*
Landline number
Email
*
Are you pregnant?
*
Please select option
Yes
No
Due date
(dd/mm/yyyy)
DD slash MM slash YYYY
Nationality
*
Please select option
Afghan
Albanian
Algerian
American
Andorran
Angolan
Antiguans
Argentinian
Armenian
Australian
Austrian
Azerbaijani
Bahamian
Bahraini
Bangladeshi
Barbadian
Barbudans
Batswana
Belarusian
Belgian
Belizian
Beninese
Bhutanese
Bolivian
Bosnian
Brazilian
British
Bruneian
Bulgarian
Burkinabe
Burmese
Burundian
Cambodian
Camoeroonian
Canadian
Cape Verdean
Central African
Chadian
Chilean
Chinese
Colombian
Comorian
Congolese
Costa Rican
Croatian
Cuban
Cypriot
Czech
Danish
Djibouti
Dominican
Dutch
East Timorese
Ecuadorian
Egyptian
Emirian
Ecuadorian Guinean
Eritrean
Estonian
Ethiopian
Fijian
Filipino
Finnish
French
Gabonese
Gambian
Georgian
German
Ghanian
Greek
Grenadian
Guatemalan
Guinea-Bissauan
Guinean
Guyanese
Haitian
Herzegovinian
Honduran
Hungarian
I-Kiribati
Icelander
Indian
Indonesian
Iranian
Iraqi
Irish
Israeli
Italian
Ivorian
Jamaican
Japanese
Jordinian
Kazakhstani
Kenyan
Kittian and Nevisian
Kuwaiti
Kyrgyz
Laotian
Latvian
Lebonese
Liberian
Libyan
Liechtensteiner
Lithuanian
Luxembourger
Macedonian
Malagasy
Malawian
Malaysian
Maldixvan
Malian
Maltese
Marshallese
Mauritian
Mexican
Micronesian
Moldovan
Monacan
Mongolian
Moroccan
Mosotho
Motswana
Mozambican
Namibian
Nauruan
Nepalese
Netherlander
New Zealander
Ni-Vanuatu
Nicaraguan
Nigerian
North Korean
Northern Irish
Norwegian
Omani
Pakistani
Palauan
Panamanian
Papa New Guinean
Paraguayan
Peruvian
Polish
Portugese
Qatari
Romanian
Russian
Rwandan
Saint Lucian
Salvadoran
Samoan
San Marinese
Sao Tomean
Saudi
Scottish
Senegalese
Serbian
Seychellois
Sierra Leonean
Singaporean
Slovakian
Slovenian
Solomon Islander
Somali
South African
South Korean
Spanish
Sri Lankan
Sudanese
Surinamer
Swazi
Swedish
Swiss
Syrian
Taiwanese
Tajik
Tanzanian
Thai
Togolese
Tongan
Trinidadian or Tobagonian
Tunisian
Turkish
Tuvaluan
Ugandan
Ukranian
Uruguayan
Uzbekistani
Venezuelan
Vietnamese
Welsh
Yemenite
Zambian
Zimbabwean
Please select next once complete or if no questions are visible
Other household members
First name
*
Last name
*
Gender
*
Please select option
Male
Female
Non-binary
Prefer not to answer
NI number
Date of birth
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Access only?
*
Please select option
Yes
No
Access means that the applicant is not in receipt of Child Benefit, but has their child living with them part-time.
Employment status
*
Please select option
Employed Full-Time
Employed Part-Time
Self-employed
Not employed but looking for work
Not employed and not looking for work
Homemaker
Retired
Student
Under 16
Nationality
*
Please select option
Afghan
Albanian
Algerian
American
Andorran
Angolan
Antiguans
Argentinian
Armenian
Australian
Austrian
Azerbaijani
Bahamian
Bahraini
Bangladeshi
Barbadian
Barbudans
Batswana
Belarusian
Belgian
Belizian
Beninese
Bhutanese
Bolivian
Bosnian
Brazilian
British
Bruneian
Bulgarian
Burkinabe
Burmese
Burundian
Cambodian
Camoeroonian
Canadian
Cape Verdean
Central African
Chadian
Chilean
Chinese
Colombian
Comorian
Congolese
Costa Rican
Croatian
Cuban
Cypriot
Czech
Danish
Djibouti
Dominican
Dutch
East Timorese
Ecuadorian
Egyptian
Emirian
Ecuadorian Guinean
Eritrean
Estonian
Ethiopian
Fijian
Filipino
Finnish
French
Gabonese
Gambian
Georgian
German
Ghanian
Greek
Grenadian
Guatemalan
Guinea-Bissauan
Guinean
Guyanese
Haitian
Herzegovinian
Honduran
Hungarian
I-Kiribati
Icelander
Indian
Indonesian
Iranian
Iraqi
Irish
Israeli
Italian
Ivorian
Jamaican
Japanese
Jordinian
Kazakhstani
Kenyan
Kittian and Nevisian
Kuwaiti
Kyrgyz
Laotian
Latvian
Lebonese
Liberian
Libyan
Liechtensteiner
Lithuanian
Luxembourger
Macedonian
Malagasy
Malawian
Malaysian
Maldivan
Malian
Maltese
Marshallese
Mauritian
Mexican
Micronesian
Moldovan
Monacan
Mongolian
Moroccan
Mosotho
Motswana
Mozambican
Namibian
Nauruan
Nepalese
Netherlander
New Zealander
Ni-Vanuatu
Nicaraguan
Nigerian
North Korean
Northern Irish
Norwegian
Omani
Pakistani
Palauan
Panamanian
Papa New Guinean
Paraguayan
Peruvian
Polish
Portugese
Qatari
Romanian
Russian
Rwandan
Saint Lucian
Salvadoran
Samoan
San Marinese
Sao Tomean
Saudi
Scottish
Senegalese
Serbian
Seychellois
Sierra Leonean
Singaporean
Slovakian
Slovenian
Solomon Islander
Somali
South African
South Korean
Spanish
Sri Lankan
Sudanese
Surinamer
Swazi
Swedish
Swiss
Syrian
Taiwanese
Tajik
Tanzanian
Thai
Togolese
Tongan
Trinidadian or Tobagonian
Tunisian
Turkish
Tuvaluan
Ugandan
Ukranian
Uruguayan
Uzbekistani
Venezuelan
Vietnamese
Welsh
Yemenite
Zambian
Zimbabwean
Are there any other household members to add to the application?
*
(Children, friends, other family members etc.)
Please select option
Yes
No
Other household members
First name
*
Last name
*
Gender
*
Please select option
Male
Female
Non-binary
Prefer not to answer
NI number
Date of birth
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Access only?
*
Please select option
Yes
No
Access means that the applicant is not in receipt of child benefit, but has their child living with them part-time.
Employment status
*
Please select option
Employed Full-Time
Employed Part-Time
Self-employed
Not employed but looking for work
Not employed and not looking for work
Homemaker
Retired
Student
Under 16
Nationality
*
Please select option
Afghan
Albanian
Algerian
American
Andorran
Angolan
Antiguans
Argentinian
Armenian
Australian
Austrian
Azerbaijani
Bahamian
Bahraini
Bangladeshi
Barbadian
Barbudans
Batswana
Belarusian
Belgian
Belizian
Beninese
Bhutanese
Bolivian
Bosnian
Brazilian
British
Bruneian
Bulgarian
Burkinabe
Burmese
Burundian
Cambodian
Camoeroonian
Canadian
Cape Verdean
Central African
Chadian
Chilean
Chinese
Colombian
Comorian
Congolese
Costa Rican
Croatian
Cuban
Cypriot
Czech
Danish
Djibouti
Dominican
Dutch
East Timorese
Ecuadorian
Egyptian
Emirian
Ecuadorian Guinean
Eritrean
Estonian
Ethiopian
Fijian
Filipino
Finnish
French
Gabonese
Gambian
Georgian
German
Ghanian
Greek
Grenadian
Guatemalan
Guinea-Bissauan
Guinean
Guyanese
Haitian
Herzegovinian
Honduran
Hungarian
I-Kiribati
Icelander
Indian
Indonesian
Iranian
Iraqi
Irish
Israeli
Italian
Ivorian
Jamaican
Japanese
Jordinian
Kazakhstani
Kenyan
Kittian and Nevisian
Kuwaiti
Kyrgyz
Laotian
Latvian
Lebonese
Liberian
Libyan
Liechtensteiner
Lithuanian
Luxembourger
Macedonian
Malagasy
Malawian
Malaysian
Maldivan
Malian
Maltese
Marshallese
Mauritian
Mexican
Micronesian
Moldovan
Monacan
Mongolian
Moroccan
Mosotho
Motswana
Mozambican
Namibian
Nauruan
Nepalese
Netherlander
New Zealander
Ni-Vanuatu
Nicaraguan
Nigerian
North Korean
Northern Irish
Norwegian
Omani
Pakistani
Palauan
Panamanian
Papa New Guinean
Paraguayan
Peruvian
Polish
Portugese
Qatari
Romanian
Russian
Rwandan
Saint Lucian
Salvadoran
Samoan
San Marinese
Sao Tomean
Saudi
Scottish
Senegalese
Serbian
Seychellois
Sierra Leonean
Singaporean
Slovakian
Slovenian
Solomon Islander
Somali
South African
South Korean
Spanish
Sri Lankan
Sudanese
Surinamer
Swazi
Swedish
Swiss
Syrian
Taiwanese
Tajik
Tanzanian
Thai
Togolese
Tongan
Trinidadian or Tobagonian
Tunisian
Turkish
Tuvaluan
Ugandan
Ukranian
Uruguayan
Uzbekistani
Venezuelan
Vietnamese
Welsh
Yemenite
Zambian
Zimbabwean
Are there any other household members to add to the application?
*
(Children, friends, other family members etc.)
Please select option
Yes
No
Other household members
First name
*
Last name
*
Gender
*
Please select option
Male
Female
Non-binary
Prefer not to answer
NI number
Date of birth
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Access only?
*
Please select option
Yes
No
Access means that the applicant is not in receipt of child benefit, but has their child living with them part-time.
Employment status
*
Please select option
Employed Full-Time
Employed Part-Time
Self-employed
Not employed but looking for work
Not employed and not looking for work
Homemaker
Retired
Student
Under 16
Nationality
*
Please select option
Afghan
Albanian
Algerian
American
Andorran
Angolan
Antiguans
Argentinian
Armenian
Australian
Austrian
Azerbaijani
Bahamian
Bahraini
Bangladeshi
Barbadian
Barbudans
Batswana
Belarusian
Belgian
Belizian
Beninese
Bhutanese
Bolivian
Bosnian
Brazilian
British
Bruneian
Bulgarian
Burkinabe
Burmese
Burundian
Cambodian
Camoeroonian
Canadian
Cape Verdean
Central African
Chadian
Chilean
Chinese
Colombian
Comorian
Congolese
Costa Rican
Croatian
Cuban
Cypriot
Czech
Danish
Djibouti
Dominican
Dutch
East Timorese
Ecuadorian
Egyptian
Emirian
Ecuadorian Guinean
Eritrean
Estonian
Ethiopian
Fijian
Filipino
Finnish
French
Gabonese
Gambian
Georgian
German
Ghanian
Greek
Grenadian
Guatemalan
Guinea-Bissauan
Guinean
Guyanese
Haitian
Herzegovinian
Honduran
Hungarian
I-Kiribati
Icelander
Indian
Indonesian
Iranian
Iraqi
Irish
Israeli
Italian
Ivorian
Jamaican
Japanese
Jordinian
Kazakhstani
Kenyan
Kittian and Nevisian
Kuwaiti
Kyrgyz
Laotian
Latvian
Lebonese
Liberian
Libyan
Liechtensteiner
Lithuanian
Luxembourger
Macedonian
Malagasy
Malawian
Malaysian
Maldivan
Malian
Maltese
Marshallese
Mauritian
Mexican
Micronesian
Moldovan
Monacan
Mongolian
Moroccan
Mosotho
Motswana
Mozambican
Namibian
Nauruan
Nepalese
Netherlander
New Zealander
Ni-Vanuatu
Nicaraguan
Nigerian
North Korean
Northern Irish
Norwegian
Omani
Pakistani
Palauan
Panamanian
Papa New Guinean
Paraguayan
Peruvian
Polish
Portugese
Qatari
Romanian
Russian
Rwandan
Saint Lucian
Salvadoran
Samoan
San Marinese
Sao Tomean
Saudi
Scottish
Senegalese
Serbian
Seychellois
Sierra Leonean
Singaporean
Slovakian
Slovenian
Solomon Islander
Somali
South African
South Korean
Spanish
Sri Lankan
Sudanese
Surinamer
Swazi
Swedish
Swiss
Syrian
Taiwanese
Tajik
Tanzanian
Thai
Togolese
Tongan
Trinidadian or Tobagonian
Tunisian
Turkish
Tuvaluan
Ugandan
Ukranian
Uruguayan
Uzbekistani
Venezuelan
Vietnamese
Welsh
Yemenite
Zambian
Zimbabwean
Are there any other household members to add to the application?
*
(Children, friends, other family members etc.)
Please select option
Yes
No
Other household members
First name
*
Last name
*
Gender
*
Please select option
Male
Female
Non-binary
Prefer not to answer
NI number
Date of birth
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Access only?
*
Please select option
Yes
No
Access means that the applicant is not in receipt of child benefit, but has their child living with them part-time.
Employment status
*
Please select option
Employed Full-Time
Employed Part-Time
Self-employed
Not employed but looking for work
Not employed and not looking for work
Homemaker
Retired
Student
Under 16
Nationality
*
Please select option
Afghan
Albanian
Algerian
American
Andorran
Angolan
Antiguans
Argentinian
Armenian
Australian
Austrian
Azerbaijani
Bahamian
Bahraini
Bangladeshi
Barbadian
Barbudans
Batswana
Belarusian
Belgian
Belizian
Beninese
Bhutanese
Bolivian
Bosnian
Brazilian
British
Bruneian
Bulgarian
Burkinabe
Burmese
Burundian
Cambodian
Camoeroonian
Canadian
Cape Verdean
Central African
Chadian
Chilean
Chinese
Colombian
Comorian
Congolese
Costa Rican
Croatian
Cuban
Cypriot
Czech
Danish
Djibouti
Dominican
Dutch
East Timorese
Ecuadorian
Egyptian
Emirian
Ecuadorian Guinean
Eritrean
Estonian
Ethiopian
Fijian
Filipino
Finnish
French
Gabonese
Gambian
Georgian
German
Ghanian
Greek
Grenadian
Guatemalan
Guinea-Bissauan
Guinean
Guyanese
Haitian
Herzegovinian
Honduran
Hungarian
I-Kiribati
Icelander
Indian
Indonesian
Iranian
Iraqi
Irish
Israeli
Italian
Ivorian
Jamaican
Japanese
Jordinian
Kazakhstani
Kenyan
Kittian and Nevisian
Kuwaiti
Kyrgyz
Laotian
Latvian
Lebonese
Liberian
Libyan
Liechtensteiner
Lithuanian
Luxembourger
Macedonian
Malagasy
Malawian
Malaysian
Maldivan
Malian
Maltese
Marshallese
Mauritian
Mexican
Micronesian
Moldovan
Monacan
Mongolian
Moroccan
Mosotho
Motswana
Mozambican
Namibian
Nauruan
Nepalese
Netherlander
New Zealander
Ni-Vanuatu
Nicaraguan
Nigerian
North Korean
Northern Irish
Norwegian
Omani
Pakistani
Palauan
Panamanian
Papa New Guinean
Paraguayan
Peruvian
Polish
Portugese
Qatari
Romanian
Russian
Rwandan
Saint Lucian
Salvadoran
Samoan
San Marinese
Sao Tomean
Saudi
Scottish
Senegalese
Serbian
Seychellois
Sierra Leonean
Singaporean
Slovakian
Slovenian
Solomon Islander
Somali
South African
South Korean
Spanish
Sri Lankan
Sudanese
Surinamer
Swazi
Swedish
Swiss
Syrian
Taiwanese
Tajik
Tanzanian
Thai
Togolese
Tongan
Trinidadian or Tobagonian
Tunisian
Turkish
Tuvaluan
Ugandan
Ukranian
Uruguayan
Uzbekistani
Venezuelan
Vietnamese
Welsh
Yemenite
Zambian
Zimbabwean
Please select next once complete or if no questions are visible
Right to Remain
For non-UK citizens
Do you have any restrictions on your right to remain in the UK, or recourse to public funds?
Please select option
Yes
No
Not applicable
If yes, please provide further information below:
Have you been granted Settled Status (or Pre-Settled Status) by the UK Home Office and can you provide evidence of this?
*
For EEA Nationals
Please select option
Yes
No
Not applicable
Address History
Current address - Main applicant
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
CĂ´te d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
TĂĽrkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ă…land Islands
Country
Date from
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Reason for leaving?
*
If we need to do a home visit can we visit this address?
*
Please select option
Yes
No
If no, why?
*
If no, what is the address to be visited?
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
CĂ´te d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
TĂĽrkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ă…land Islands
Country
Current address - Joint applicant
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
CĂ´te d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
TĂĽrkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ă…land Islands
Country
Date from
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Reason for leaving?
*
Which of the following best describes your situation (main applicant)?
*
Please select option
Living with family and friends
Council tenant
Housing association
Homeowner/mortgagee
Private rented (self-contained)
Private rented (room/bedsit)
Homeless/sofa surfing
Hostel
EPIC tenant
Other
If other, please specify:
*
Please give details of your current landlord, including address and phone number (if applicable):
*
What notice period do you need to give your current landlord?
*
Have you had any previous tenancies with EPIC or Bentilee Community Housing?
*
Please select option
Yes
No
If yes, what was the address and when did you live there?
*
Previous address history
Please provide your address history for the last 5 years, including the landlord details of all rented properties.
Have you lived at your current address for at least 5 years?
*
Please select option
Yes
No
Previous address 1 - Main applicant
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
CĂ´te d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
TĂĽrkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ă…land Islands
Country
Date from
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Reason for leaving?
*
Tenancy type
*
Please select option
Living with family and friends
Council tenant
Housing association
Homeowner/mortgagee
Private rented (self-contained)
Private rented (room/bedsit)
Homeless/sofa surfing
Hostel
EPIC tenant
Please give details of your landlord, including address and phone number (if applicable):
Have you lived at any other address in the past 5 years other than the above?
*
Please select option
Yes
No
Previous address 2 - Main applicant
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
CĂ´te d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
TĂĽrkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ă…land Islands
Country
Date from
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Reason for leaving?
*
Tenancy type
*
Please select option
Living with family and friends
Council tenant
Housing association
Homeowner/mortgagee
Private rented (self-contained)
Private rented (room/bedsit)
Homeless/sofa surfing
Hostel
EPIC tenant
Other
Please give details of your landlord, including address and phone number (if applicable):
Have you lived in another address other than the above in the past 5 years?
*
Please select option
Yes
No
Previous address 3 - Main applicant
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
CĂ´te d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
TĂĽrkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ă…land Islands
Country
Date from
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Reason for leaving?
*
Tenancy type
*
Please select option
Living with family and friends
Council tenant
Housing association
Homeowner/mortgagee
Private rented (self-contained)
Private rented (room/bedsit)
Homeless/sofa surfing
Hostel
EPIC tenant
Other
Please give details of your landlord, including address and phone number (if applicable):
Do you need to record a fourth previous address?
*
Please select option
Yes
No
Previous address 4 - Main applicant
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
CĂ´te d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
TĂĽrkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ă…land Islands
Country
Date from
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Reason for leaving?
*
Tenancy type
*
Please select option
Living with family and friends
Council tenant
Housing association
Homeowner/mortgagee
Private rented (self-contained)
Private rented (room/bedsit)
Homeless/sofa surfing
Hostel
EPIC tenant
Other
Please give details of your landlord, including address and phone number (if applicable):
Has the joint applicant lived at their current address for at least 5 years?
*
Please select option
Yes
No
Previous address 1 - Joint applicant
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
CĂ´te d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
TĂĽrkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ă…land Islands
Country
Date from
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Reason for leaving?
*
Tenancy type
*
Please select option
Living with family and friends
Council tenant
Housing association
Homeowner/mortgagee
Private rented (self-contained)
Private rented (room/bedsit)
Homeless/sofa surfing
Hostel
EPIC tenant
Other
Please give details of your landlord, including address and phone number (if applicable):
Do you need to record a second previous address?
*
Please select option
Yes
No
Previous address 2 - Joint applicant
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
CĂ´te d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
TĂĽrkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ă…land Islands
Country
Date from
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Reason for leaving?
*
Tenancy type
*
Please select option
Living with family and friends
Council tenant
Housing association
Homeowner/mortgagee
Private rented (self-contained)
Private rented (room/bedsit)
Homeless/sofa surfing
Hostel
EPIC tenant
Other
Please give details of your landlord, including address and phone number (if applicable):
Do you need to record a third previous address?
*
Please select option
Yes
No
Previous address 3 - Joint applicant
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
CĂ´te d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
TĂĽrkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ă…land Islands
Country
Date from
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Reason for leaving?
*
Tenancy type
*
Please select option
Living with family and friends
Council tenant
Housing association
Homeowner/mortgagee
Private rented (self-contained)
Private rented (room/bedsit)
Homeless/sofa surfing
Hostel
EPIC tenant
Other
Please give details of your landlord, including address and phone number (if applicable):
Do you need to record a fourth previous address?
*
Please select option
Yes
No
Previous address 4 - Joint applicant
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
CĂ´te d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
TĂĽrkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ă…land Islands
Country
Date from
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Reason for leaving?
*
Tenancy type
*
Please select option
Living with family and friends
Council tenant
Housing association
Homeowner/mortgagee
Private rented (self-contained)
Private rented (room/bedsit)
Homeless/sofa surfing
Hostel
EPIC tenant
Other
Please give details of your landlord, including address and phone number (if applicable):
You and your money
The first section is to be completed by the main applicant.
Are you currently in employment?
*
Please select option
Yes
No
What is your job?
*
Date from
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Who is your employer?
*
Income frequency:
*
Please select option
Weekly
Fortnightly
4 Weekly
Monthly
Other
If other, please specify:
*
What is your average income at the above frequency?
*
Contract type
*
Please select option
Full-time
Part-time
Zero hours
Temporary/agency
Give details of any benefits or other income you receive:
*
If not applicable enter N/A.
Total income (monthly)
*
Do you have a bank account?
*
Please select option
Yes
No
Do you have any savings?
*
Please select option
Yes
No
How much do you have in savings?
*
Do you own, or have you ever owned, your own home or any other properties?
*
Please select option
Yes
No
Do you have any equity?
*
Please give amount.
What is the address of the property you own(ed)?
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
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Angola
Anguilla
Antarctica
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Benin
Bermuda
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Bolivia
Bonaire, Sint Eustatius and Saba
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Bouvet Island
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Panama
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Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
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Ă…land Islands
Country
Do you have any debts?
*
Please select option
Yes
No
Please provide further details
*
Do you have any County Court Judgments against you?
*
Please select option
Yes
No
Please provide further details
*
Are you subject to a Debt Relief Order or declared bankrupt?
*
Please select option
Yes
No
Please provide further details
*
Do you owe rent for a property you have rented over the last 5 years?
*
Please select option
Yes
No
How much do you owe?
*
Do you have a payment plan in place?
*
Please select option
Yes
No
Please provide details of your payment plan:
*
Do you have any mortgage arrears?
*
Please select option
Yes
No
How much do you owe?
*
Please provide further details
*
Do you have any council tax arrears?
*
Please select option
Yes
No
How much do you owe?
*
Please provide further details
*
Please give details of any other debts you have (if applicable):
Total debts (in ÂŁ)
*
Are you currently in employment?
*
This next section is to be completed by the joint applicant.
Please select option
Yes
No
What is your job?
*
Date from
*
DD slash MM slash YYYY
(dd/mm/yyyy)
Who is your employer?
*
Income frequency:
*
Please select option
Weekly
Fortnightly
4 Weekly
Monthly
Other
If other, please specify:
*
What is your average income at the above frequency?
*
Contract type
*
Please select option
Full-time
Part-time
Zero hours
Temporary/agency
Give details of any benefits or other income you receive:
*
If not applicable enter N/A.
Total income (monthly)
*
Do you have a bank account?
*
Please select option
Yes
No
Do you have any savings?
*
Please select option
Yes
No
How much do you have in savings?
*
Do you own, or have you ever owned, your own home or any other properties?
*
Please select option
Yes
No
Do you have any equity?
*
Please give amount.
Do you have any debts?
*
Please select option
Yes
No
Please provide further information
*
Do you have any County Court Judgments against you?
*
Please select option
Yes
No
Please provide further details
*
Are you subject to a Debt Relief Order or declared bankrupt?
*
Please select option
Yes
No
Please provide further information
*
Do you owe rent for a property you have rented over the last 5 years?
*
Please select option
Yes
No
How much do you owe?
*
Do you have a payment plan in place?
*
Please select option
Yes
No
Please provide details of your payment plan:
*
Do you have any mortgage arrears?
*
Please select option
Yes
No
How much do you owe?
*
Please provide further information
*
Do you have any council tax arrears?
*
Please select option
Yes
No
How much do you owe?
*
Please provide further information
*
Please give details of any other debts you have (if applicable):
Total debts (in ÂŁ)
*
More about you
Please tell us about activity criminal activity that you, or any other applicant, have been involved in.
Have you ever been arrested?
*
Please select option
Yes
No
Have you ever been cautioned or charged for any offence?
*
Please select option
Yes
No
Have you ever been convicted of a criminal offence?
*
Please select option
Yes
No
Please give details below:
*
(Including dates of any arrests/cautions/convictions, details of the offence/arrest and any sentence received)
Do you have any pending investigations which may result in a charge?
*
Please select option
Yes
No
Please give details below:
*
Have you, your partner or any member of your household ever been involved in or caused any Anti-Social Behaviour (this is any aggressive, intimidating or destructive activity that destroys another person's quality of life)?
*
Please select option
Yes
No
Has a court ever made an order that you should do, or not do something?
*
Please select option
Yes
No
Have you ever lost your home for causing nuisance or anti-social behaviour?
*
Please select option
Yes
No
Have you ever been a victim of crime including ASB, domestic violence or threats from another person?
*
Please select option
Yes
No
If yes to any of the above, please give details below:
*
Are you related to anyone who is, or has in the last 12 months, been a Board Member or has been employed by EPIC?
*
Please select option
Yes
No
Please give details below:
*
Have you applied for housing with EPIC before?
*
Please select option
Yes
No
Are you, your partner or anyone in the household applying for housing on medical/disability grounds, or because the property where you live now is unsuitable?
*
Please select option
Yes
No
Please give further details below:
*
Do you have a letter from a doctor or consultant that would tell us about this?
*
Please select option
Yes
No
Do you (or anyone in the household) use a wheelchair?
*
Please select option
Yes
No
Please tell us if you have any physical or mental health issues. Please tell us if you are on any medication or other treatment for any condition.
Your property needs
In which area are you looking for housing?
*
Please select option
Stoke-on-Trent
Newcastle-under-Lyme
Staffordshire Moorlands
Other
Please give details:
*
Do you have any pets?
*
Please be aware that we do not allow dogs in our blocks of six flats unless the dog is registered for assisting someone with a visual or hearing difficulty. If you wish to keep any pets you will need to get our permission.
Yes
No
What type of pet(s) do you have?
*
Select All
Cat
Dog
Rabbit/guinea pig
Bird
Other
Please provide some additional information about your pet(s):
*
(Include number of pets, breeds etc.)
Please state any specific requirements on the type of property you are applying for (e.g. ground floor due to mobility problems):
Do you have any children from a previous relationship that will be staying with you on a regular basis?
*
Please select option
Yes
No
Please use the space below to provide details of gender, age and how often they will stay:
*
Do you receive Child Benefit for the children that will be staying with you?
*
Please select option
Yes
No
If you require a property with a greater number of bedrooms than you would normally be eligible for then please provide details of any exceptional circumstances to support your request, including any health considerations:
Supporting documents
As part of your application you need to provide evidence of identity and income. Please ensure that all proofs are clear and easy to read prior to submission, otherwise we will be unable to process your application. The attachments must be uploaded as one of the following file types: jpg, gif, png, pdf.
Proof of identity - Main applicant
*
Passport or national ID card, or two of the following: driving license, full birth certificate, recent benefit letter, signed letter from employer.
Drop files here or
Select files
Max. file size: 25 MB.
Proof of Settled Status - Main applicant
*
Drop files here or
Select files
Max. file size: 25 MB.
Proof of address - Main applicant
*
2 letters required e.g. utility bill dated within the last 3 months.
Drop files here or
Select files
Max. file size: 25 MB.
Proof of income - Main applicant
*
For the last 3 months e.g. bank statements, Universal Credit, or any other benefits awards letter.
Max. file size: 25 MB.
Proof of national insurance number - Main applicant
*
Drop files here or
Select files
Max. file size: 25 MB.
Landlord Permission- Main Applicant
*
If you currently rent, please could you provide handwritten and signed confirmation that you give EPIC permission to retrieve a landlord reference. Please could this be signed with today's date. Examples include: "I Joe Bloggs, give EPIC Housing permission to retrieve a landlord reference for 123 Street 14.09.21 *signed*".
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Select files
Max. file size: 25 MB.
Proof of pregnancy (if applicable) - Main applicant
Max. file size: 25 MB.
Tenancy agreement (if applicable) - Main applicant
Max. file size: 25 MB.
Proof of identity - Joint applicant
*
Passport or national ID card, or two of the following: driving license, full birth certificate, recent benefit letter, signed letter from employer.
Drop files here or
Select files
Max. file size: 25 MB.
Proof of Settled Status - Joint applicant
*
Drop files here or
Select files
Max. file size: 25 MB.
Proof of address - Joint applicant
*
2 letters required e.g. utility bill dated within the last 3 months.
Drop files here or
Select files
Max. file size: 25 MB.
Proof of income - Joint applicant
*
For the last 3 months e.g. bank statements, Universal Credit, or any other benefits awards letter.
Drop files here or
Select files
Max. file size: 25 MB.
Proof of national insurance number - Joint applicant
*
Drop files here or
Select files
Max. file size: 25 MB.
Proof of pregnancy (if applicable) - Joint applicant
Max. file size: 25 MB.
Tenancy agreement (if applicable) - Joint applicant
Max. file size: 25 MB.
Proof of identity - Household member 1 (if applicable)
Passport or national ID card, or two of the following: driving license, full birth certificate, recent benefit letter, signed letter from employer. Birth certificate sufficient if household member under 18.
Drop files here or
Select files
Max. file size: 25 MB.
Proof of address - Household member 1 (if applicable)
Only required for adult household members. 2 letters required e.g. utility bill dated within the last 3 months.
Max. file size: 25 MB.
Proof of income - Household member 1 (if applicable)
Only required for adult household members. For the last 3 months e.g. bank statements, Universal Credit, or any other benefits awards letter.
Max. file size: 25 MB.
Proof of national insurance number - Household member 1 (if applicable)
Max. file size: 25 MB.
Tenancy agreement - Household member 1 (if applicable)
Max. file size: 25 MB.
Proof of pregnancy - Household member 1 (if applicable)
Max. file size: 25 MB.
Proof of identity - Household member 2
*
Passport or national ID card, or two of the following: driving license, full birth certificate, recent benefit letter, signed letter from employer. Birth certificate sufficient if household member under 18.
Drop files here or
Select files
Max. file size: 25 MB.
Proof of address - Household member 2 (if applicable)
Only required for adult household members. 2 letters required e.g. utility bill dated within the last 3 months.
Drop files here or
Select files
Max. file size: 25 MB.
Proof of income - Household member 2 (if applicable)
Only required for adult household members. For the last 3 months e.g. bank statements, Universal Credit, or any other benefits awards letter.
Drop files here or
Select files
Max. file size: 25 MB.
Proof of national insurance number - Household member 2 (if applicable)
Drop files here or
Select files
Max. file size: 25 MB.
Tenancy agreement - Household member 2 (if applicable)
Drop files here or
Select files
Max. file size: 25 MB.
Proof of pregnancy - Household member 2 (if applicable)
Drop files here or
Select files
Max. file size: 25 MB.
Proof of identity - Household member 3
*
Passport or national ID card, or two of the following: driving license, full birth certificate, recent benefit letter, signed letter from employer. Birth certificate sufficient if household member under 18.
Drop files here or
Select files
Max. file size: 25 MB.
Proof of address - Household member 3 (if applicable)
Only required for adult household members. 2 letters required e.g. utility bill dated within the last 3 months.
Drop files here or
Select files
Max. file size: 25 MB.
Proof of income - Household member 3 (if applicable)
Only required for adult household members. For the last 3 months e.g. bank statements, Universal Credit, or any other benefits awards letter.
Drop files here or
Select files
Max. file size: 25 MB.
Proof of national insurance number - Household member 3 (if applicable)
Drop files here or
Select files
Max. file size: 25 MB.
Tenancy agreement - Household member 3 (if applicable)
Max. file size: 25 MB.
Proof of pregnancy - Household member 3 (if applicable)
Max. file size: 25 MB.
Proof of identity - Household member 4
*
Passport or national ID card, or two of the following: driving license, full birth certificate, recent benefit letter, signed letter from employer. Birth certificate sufficient if household member under 18.
Max. file size: 25 MB.
Proof of address - Household member 4 (if applicable)
Only required for adult household members. 2 letters required e.g. utility bill dated within the last 3 months.
Max. file size: 25 MB.
Proof of income - Household member 4 (if applicable)
Only required for adult household members. For the last 3 months e.g. bank statements, Universal Credit, or any other benefits awards letter.
Max. file size: 25 MB.
Proof of national insurance number - Household member 4 (if applicable)
Max. file size: 25 MB.
Tenancy agreement - Household member 4 (if applicable)
Max. file size: 25 MB.
Proof of pregnancy - Household member 4 (if applicable)
Max. file size: 25 MB.
Privacy policy and consent form
Do you consent to being contacted via email to complete a feedback survey following submission of this application?
*
Please select option
Yes
No
Your opinion and feedback is important to us. All survey responses will only be used to improve the applicant experience and will in no way impact the outcome of your application.
Consent - Main applicant
*
I agree to the privacy policy.
To undertake the function of providing effective housing, we have to obtain, process and store personal information about our applicants and tenants. This policy details our obligations on how we treat your personal details.
To allow us to use your personal information we require you to give consent. Please read this carefully and sign the consent below.
What is personal information?
Personal information is information that relates to a living individual and allows that individual to be identified. Certain types of personal information is categorised as *sensitive personal data (see below).
How do we collect information?
You may provide personal information to us when you make or respond to a housing application, when dealing with your tenancy, when requesting repairs on a property, when making other contact in relation to you, your application, your tenancy or when a member of our staff has initiated a contact with you in relation to you, your application, your tenancy or any other reason.
Whenever you communicate with us we may need to obtain personal information about you to enable us to perform any actions that may be required as a result of the contact.
We will only request personal information that is appropriate for our business functions, and you may refuse to provide information if you deem any requests to be inappropriate. Please note that we may not be able to carry out EPIC’s work for you if you refuse to provide information that stops us doing so.
We may also obtain your personal details from organisations you have dealt with, such as past landlords, councils and other agencies.
How do we use your information?
The purposes for which we process your personal information are:
- To allow us to assess your housing application.
- To manage your tenancy and to provide services to you such as repairs, garden maintenance etc.
- To conduct surveys and statistics on tenant profiles in order to improve services and report on our performance.
- To provide you with information about EPIC or other services that may be of interest to you.
- To enable us to comply with our legal and regulatory obligations.
- To assist you in accessing help, advice and support that we or our partners offer.
Who may we disclose your personal details to?
- We may need to provide your personal details such as name, address and contact details to our contractors and suppliers of services to ensure that you receive services such as repairs, planned maintenance, garden maintenance and other services you are entitled to.
- We may be required by law to disclose your personal details in order to comply with applicable laws and lawful requests, this could include disclosing personal details to Stoke on Trent City Council or the Department of Work and Pensions.
- We may be required to provide information to our Regulators.
Storing your personal information:
We are committed to protecting your personal details and so keep your information locked in a secure place at all times.
Ensuring the accuracy of your personal information:
We are committed to keeping your personal details accurate. Please inform staff of any changes in your personal details. You may have access to your personal details upon request.
Your consent—We require you to sign to give your consent before we can proceed with your housing application.
I/we give consent to EPIC to hold and process personal information (including sensitive personal data as set out) that I have provided or will provide in the future to perform the functions of EPIC as set out in the Privacy Policy above.
I/we agree to provide a photograph of myself / ourselves and any other member of the household and that you can keep the photographs for as long as the tenancy lasts or that person remains a member of the household.’
*Sensitive personal data means personal data consisting of information as to (a) the racial or ethnic origin of the data subject, (b) his/her political opinions, (c ) his/her religious beliefs or other beliefs of a similar nature, (d) whether he/she is a member of a trade union (within the meaning of the Trade Union and Labour Relations (Consolidation) Act 1992), (e) his/her physical or mental health or condition, (f) his/her sexual life, (g) the commission or alleged commission by him/her of any offence, or (h) any proceedings for any offence committed or alleged to have been committed by him/her, the disposal of such proceedings or the sentence of any court in such proceedings.
Consent - Joint applicant
*
I agree to the privacy policy.
To undertake the function of providing effective housing, we have to obtain, process and store personal information about our applicants and tenants. This policy details our obligations on how we treat your personal details.
To allow us to use your personal information we require you to give consent. Please read this carefully and sign the consent below.
What is personal information?
Personal information is information that relates to a living individual and allows that individual to be identified. Certain types of personal information is categorised as *sensitive personal data (see below).
How do we collect information?
You may provide personal information to us when you make or respond to a housing application, when dealing with your tenancy, when requesting repairs on a property, when making other contact in relation to you, your application, your tenancy or when a member of our staff has initiated a contact with you in relation to you, your application, your tenancy or any other reason.
Whenever you communicate with us we may need to obtain personal information about you to enable us to perform any actions that may be required as a result of the contact.
We will only request personal information that is appropriate for our business functions, and you may refuse to provide information if you deem any requests to be inappropriate. Please note that we may not be able to carry out EPIC’s work for you if you refuse to provide information that stops us doing so.
We may also obtain your personal details from organisations you have dealt with, such as past landlords, councils and other agencies.
How do we use your information?
The purposes for which we process your personal information are:
- To allow us to assess your housing application.
- To manage your tenancy and to provide services to you such as repairs, garden maintenance etc.
- To conduct surveys and statistics on tenant profiles in order to improve services and report on our performance.
- To provide you with information about EPIC or other services that may be of interest to you.
- To enable us to comply with our legal and regulatory obligations.
- To assist you in accessing help, advice and support that we or our partners offer.
Who may we disclose your personal details to?
- We may need to provide your personal details such as name, address and contact details to our contractors and suppliers of services to ensure that you receive services such as repairs, planned maintenance, garden maintenance and other services you are entitled to.
- We may be required by law to disclose your personal details in order to comply with applicable laws and lawful requests, this could include disclosing personal details to Stoke on Trent City Council or the Department of Work and Pensions.
- We may be required to provide information to our Regulators.
Storing your personal information:
We are committed to protecting your personal details and so keep your information locked in a secure place at all times.
Ensuring the accuracy of your personal information:
We are committed to keeping your personal details accurate. Please inform staff of any changes in your personal details. You may have access to your personal details upon request.
Your consent—We require you to sign to give your consent before we can proceed with your housing application.
I/we give consent to EPIC to hold and process personal information (including sensitive personal data as set out) that I have provided or will provide in the future to perform the functions of EPIC as set out in the Privacy Policy above.
I/we agree to provide a photograph of myself / ourselves and any other member of the household and that you can keep the photographs for as long as the tenancy lasts or that person remains a member of the household.’
*Sensitive personal data means personal data consisting of information as to (a) the racial or ethnic origin of the data subject, (b) his/her political opinions, (c ) his/her religious beliefs or other beliefs of a similar nature, (d) whether he/she is a member of a trade union (within the meaning of the Trade Union and Labour Relations (Consolidation) Act 1992), (e) his/her physical or mental health or condition, (f) his/her sexual life, (g) the commission or alleged commission by him/her of any offence, or (h) any proceedings for any offence committed or alleged to have been committed by him/her, the disposal of such proceedings or the sentence of any court in such proceedings.
Declaration - Main applicant
*
I confirm that the information I have provided is accurate and true.
EPIC takes the issues of fraud and deception very seriously. We work closely with our partners to check information given and we will take the firmest possible action if we find that people have given us false information or have refused to reveal appropriate information to their application.
I confirm that all the information disclosed and recorded in this form is accurate and true. I have not concealed any information which would be relevant to my application. I understand that EPIC will take the firmest possible action if fraud or concealment is discovered. I understand that fraud is a criminal offence. I consent to EPIC approaching current and former landlords for a reference concerning the conduct of previous tenancies. I consent to EPIC sharing the data collected in this form with relevant statutory agencies and partner organisations. I understand that I must notify EPIC of any changes in the details given in this form as soon as possible.
Declaration - Joint applicant
*
I confirm that the information I have provided is accurate and true.
EPIC takes the issues of fraud and deception very seriously. We work closely with our partners to check information given and we will take the firmest possible action if we find that people have given us false information or have refused to reveal appropriate information to their application.
I confirm that all the information disclosed and recorded in this form is accurate and true. I have not concealed any information which would be relevant to my application. I understand that EPIC will take the firmest possible action if fraud or concealment is discovered. I understand that fraud is a criminal offence. I consent to EPIC approaching current and former landlords for a reference concerning the conduct of previous tenancies. I consent to EPIC sharing the data collected in this form with relevant statutory agencies and partner organisations. I understand that I must notify EPIC of any changes in the details given in this form as soon as possible.
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