Application for Council Tax Discount

*Name:
*Address:
*Postcode:
*Date of Birth: dd/mm/yyyy

For security purposes, please supply your date of birth
*Telephone:

Please supply a daytime telephone number in case of query
*Email:
*Confirm Email:
Council Tax Reference No:

Please provide your Council Tax reference number if known.

Please complete Part A if you wish to apply for a single person discount or Part B for a Status Disregard.

Part A - Single Person Discount

A single person discount will be awarded if you are the sole adult occupier over the age of 18. If you have a partner or other person who normally lives with you and they are living away or temporarily absent you will not be entitled to a single person discount. If you are at all unsure of your eligibility please contact Local Taxation on 01480 388030 before completing this form.

I became the Council Tax payer for this address on:

 dd/mm/yyyy

I wish to claim a single person discount from:

 dd/mm/yyyy
Are you claiming a single person discount following one of these changes:
A person living with you has died?
Your husband / wife / partner / other person(s) moving out?

If yes, please give the full name of the person(s) who has moved out and their new address:
Name:
Address:

Please list all people who live in the property (including yourself)

Name

Date of Birth
dd/mm/yyyy

 Relationship to You










Part B - Status Disregard

Status disregards can be awarded in certain circumstances e.g. Students, School Leavers and Visiting Forces.

For full details of these please see our Discount page or Disregards page

I wish to apply for a status disregard in respect of myself and/or the following person(s):

Name Disregard applied for

We may ask you to complete additional forms if necessary to verify the discount applied for. These will be issued when this completed form is submitted.

Warning:

Under Regulation 16, The Council Tax (Administration and Enforcement) Regulations 1992 - you must tell the District Council if you are no longer entitled to claim this discount. You must do this, in writing, within 21 days if your circumstances change. If you knowingly claim a discount, to which you are not entitled, this may lead to a criminal prosecution being taken against you and a penalty of £70.00 being incurred.

Declaration:

* I certify that the above details are correct. I understand that, if I give false information, I will be liable to pay a penalty of £70.00. *

*Mandatory field

If you think a friend would like to use this application, please use our 'send to a friend' form

All personal details are held in accordance with the councils Data Protection Policy - Privacy Disclaimer


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