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Change of Circumstances Form

Your Details
Title
Please include the date it took place and any other relevant information.
Circumstances
Have you or your partner started work, changed employer, changed the number of hours you work or has your pay gone up or down?
Have you or your partner started work, changed employer and/or hours?
You
How often are you paid?
How are you paid?
Please upload payslips or arrange to submit paper copies to your local Service Point or post to Kintyre House, Snipefield Ind Estate, Campbeltown, PA28 6SY
Maximum 10 files.
8 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, rtf, pdf, doc, docx, xls, xlsx.
Have you applied for tax credits?
Are you self employed?
If you are we will need to contact you for further information.
Your Partner
How often are you paid?
Please upload payslips or arrange to submit paper copies to your local Service Point or post to Kintyre House, Snipefield Ind Estate, Campbeltown, PA28 6SY
Maximum 10 files.
8 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, rtf, pdf, doc, docx, xls, xlsx.
Have you applied for tax credits?
Are you self employed?
If you are we will need to contact you for further information.
Have you changed your address or are you going to change your address soon?
Change of address
What type of property is your new address?
Is the property?
Does your new home have central heating?
Do you have a garage?
Is your landlord responsible for decorating inside your home?
Is your new home furnished by your landlord?
Please tell us about the rooms in your new home
Please tell us the number of rooms used by you and your family for each type below
Please tell us the number of other tenants you share rooms with for each room type below
Please tell us the number of rooms you share with other tenants for each room type below
Your rent
Please upload a copy of your lease agreement or arrange to submit a paper copy to your local Service Point or post to Kintyre House, Snipefield Ind Estate, Campbeltown, PA28 6SY
One file only.
64 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
Do you have weeks when you do not have to pay rent?
If you are a Housing Association tenant, do you want your benefit paid to your landlord?
Some charges for services such as heating, hot water and meals will not qualify for housing benefit.  They must be deducted from your rent if it includes them. If you cannot tell us how much they are we will deduct the standard amounts.  Please tick which of these are included in your rent.
Included in your rent
Do you receive any meals?
Overlapping benefit on two homes

We may be able to pay benefit for two homes for up to a maximum of four weeks.  If you have been “HELD TO NOTICE” at your previous address and have to pay rent for both properties you may be entitled to claim benefit.

Do you wish to apply for Held to Notice overlapping benefit?
Please give reasons and supply proof to support your claim

If there has been a delay in moving due to adaptations to the property due to disability and you are liable for the rent on both properties or you are waiting for a social fund loan to assist with the removal you may be entitled to claim benefit.

If you have had to move through ‘fear of violence’ and you intend to return to the property you have left you may be entitled to benefit for both properties.

Please give reasons and supply proof to support your claim
Anything else you think we should know
Is there anything else you think we should know about?
Maximum 10 files.
8 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, rtf, pdf, doc, docx, xls, xlsx.
What is your preferred method of contact should we require further information?
Declaration
This is a change connected to my claim for housing benefit and/or council tax reduction scheme with ߣsirÊÓƵ and Bute Council. I confirm that as far as I am aware the information I have given on this form is accurate and complete.

I give ߣsirÊÓƵ and Bute Council permission to make any necessary enquiries to check the information on this form.  I understand that if I give information that is not correct or complete, or I do not tell the council benefit section about any changes that may affect my benefit then my payments of benefit may be suspended and I may be liable to prosecution.

The council is under an obligation to manage public funds properly; accordingly information that you provide will be used to ensure appropriate payment of housing benefit and council tax reduction scheme. The information may be shared with other authorised bodies in order to prevent and detect fraud.

This authority operates within Government guidelines of best practice, which means you will in the lifetime of your claim receive a visit or visits from council benefit officers who will wish to verify that the details we hold for your claim are still current and remain unchanged.

The officer will formally identify him/herself and will fully explain the procedure to you.  Failure to cooperate with this procedure could result in suspension or cancellation of any benefit in payment.

Privacy notice

The information you have supplied on this form will be used for the purpose for which you have provided it, and appropriate measures are in place to protect your personal data.  A full privacy notice, which provides information about your rights under current data protection legislation and details about what will happen to your personal data can be found here:

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