HOUSING APPLICATION FORM

Transcription

1 HOUSING APPLICATION FORM

2 HOUSING APPLICATION FORM Please complete the following application form as fully as possible and return to the Estate Office. Full Applicant s Name Date of Birth Address Contact Address (if different from above) Post Code Telephone Number Post Code Home Work/Mobile Marital Status of Applicant (please tick) Single Married Divorced Separated Partner Spouse/Partner s Full Name Date of Birth Children/ Dependents and any other individuals living with you during tenancy Date of Birth Relationship to you

3 Employment Applicant s Current Employer Are you Self Employed? (Tick) If yes, what is the nature and structure of your business? Sole Trader Partnership Limited Compan y Franchise Other (Please Specify below) Company Name & Address Telephone Post Code Position Length of Employment Your Work is: (Tick) Full Time Part Time Other (please specify below) Spouse/Partner s Current Employer Are they Self Employed? (Tick) If yes, what is the nature and structure of their business? (Please Tick) Sole Trader Partnership Limited Compan y Franchise Other (Please Specify below) Company Name & Address

4 Telephone Post Code Position Length of Employment Their Work is: (Please tick) Full Time Part Time Other (please specify below)

5 About You What are your hobbies & interests? What are your Spouse/Partner s hobbies & interests? Brief description of current accommodation: Reasons for applying: Have you rented before? If yes, where and when? Have you lived on the Bolesworth Estate before? (Tick) Do you have any connections otherwise to the Bolesworth Estate? Do you have now or had any connection to Agriculture and/or Forestry?

6 Your Requirements Have you enquired about / applied for accommodation at Bolesworth before? Type of accommodation required: (please tick) Large House Bungalow Other (Please specify) Cottage Flat Number of Bedrooms required: Maximum affordable rental budget (Excl. Utilities and Council Tax) Length of Tenancy required? Required commencement of tenancy? Per Month Per Annum Preferred Location (Please tick) Tattenhall Harthill Don t Mind Burwardsley Handley Do you need a garden? Do you require additional land i.e. a paddock? (Tick) If yes, how much? (acres/hectares) Do you own any pets? (Tick) If yes, please detail species, breed and age. Please continue onto a separate sheet if necessary. Number of cars? Do you own any caravans, boats, cars or other that require storage or parking? Please detail. Do you consider yourself or a member of your household to have a disability as defined in the Disability Discrimination Act 1995? (If yes, we may ask for further details if appropriate or necessary.) (Please tick)

7 YES NO Further Details Do you have any unspent convictions? If, Please give details Do you have any convictions pending? (Please tick) If, Please give details Have you ever been declared bankrupt? (Please tick) If yes, Please give details Have you any County Court Judgements against you? (Please tick) If, Please give details Have you ever been served a tice to Quit? (Please tick) Do you currently claim for Government Benefits? (Please tick) If yes, please tick below as appropriate: Housing Benefit Child Tax Credit Job Seekers Allowance Other Council Tax Benefits Income Support Incapacity Benefit Please specify other:

8 Are there any other matters that may be relevant? Is there any further information that you feel supports your application? Please continue on separate sheets if necessary. How did you hear about the Bolesworth Estate?

9 Your Application: Please keep us updated with any changes in your circumstances or requirements. Your information will be kept on file until something matching your requirements becomes available, at which point we may contact you. Please check you have answered all of the questions and sign below. DECLARATION I...confirm that the information given is accurate. Signed: Date:.... The information provided on this application will be used solely for the purposes of housing allocation on the Bolesworth Estate and will not be passed to any third party. Thank you for your enquiry and for taking the time to fill out this application form. Please send to: Matthew Morris MRICS FAAV Bolesworth Estate Company Ltd The Estate Office Tattenhall Chester CH3 9HQ Or to: If you have any queries in the meantime, please do not hesitate to contact the Estate Office on or one of the above addresses.