Housing application form

Wed, 25/01/2012 - 16:43 — hbcpt

Housing Application Form A4 Jan 2012 (Download PDF)

High Bickington CPT Ltd – a Community Property Trust

 

HOUSING APPLICATION FORM                                                                                    CONFIDENTIAL

 

Please carefully read the enclosed Housing Allocation Policy and information leaflets.

 

If you feel you might qualify for CPT housing please complete all relevant sections of this form and return it to the Project Office (The Meeting Point, High Bickington) as soon as possible.

 

About you / your partner

 

 

 

Applicant 1

 

 

Applicant 2

Name

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Email address

 

 

 

Daytime

phone number

 

 

                                   

About other members of your household

 

 

Please list other

adults and children

in your household

who need

re-housing

with you

Name

Age (if under 18)

Relation to

Applicant 1

Relation to

Applicant 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are you or anyone else in the household pregnant?                           Yes                             No

 

If yes, when is the baby due?

About your current home   

If you are not living together at present, please tick both columns

as appropriate.  If living together, just tick under ‘Applicant 1’

Are you …

Applicant 1

 

Applicant 2

The Owner?

 

 

 

Council/Housing

Association tenant?

 

 

 

 

Private tenant?

 

 

 

 

           

Living with relatives?

 

 

 

Living with friends?

 

 

 

Other (please specify)

 

 

 

 

 

In what ways is your current home inadequate for your/your family’s housing needs? Please tick any that apply

 

Applicant 1

 

Applicant 2

Overcrowding

 

 

 

Poor condition

 

 

 

High rent/mortgage

 

 

 

Short term/insecure occupation

 

 

 

Other (please specify)

 

 

 

 

 

Size of accommodation needed

Please answer the following questions jointly

 


How many single or double bedrooms do you currently have access                      Single

to, for you and the people who need to be re-housed with you?                               

Double

 

Do you need more bedrooms than normal, for example because

someone in your family has a disability?                                                                       Yes               No

 

Reason ………………………………………………………………………………………………..

Do you or anyone who needs to be housed with you, have                                        

any medical circumstances which may affect the type of                               Yes                 No

accommodation you require?

           

If Yes please give details ……………………………………………………………………………

   

How many vehicles do you and the people who need re-housing have?

 

Local Connection (please indicate by which means you meet our housing allocation criteria)

Applicant 1

Applicant 2

A minimum continuous residence of five years in the parish

 

 

Residence within the parish for five years within the preceding ten years

 

 

One or both parents or guardians have resided in the parish for a minimum period of ten years

 

 

Continuous employment in the parish for the past five years

 

 

Do you currently own a property

Yes / No

Yes / No

 

 

 

 

 

Relationship to HBCPT Board & staff

 

Applicant 1

 

Applicant 2

Are you related to any of the Board members or staff of High Bickington CPT Ltd?

 

 

 

If you answered ‘yes’, please say how you are related.

 

 

 

Ethnic background

Our Equal Opportunities policy is printed at the end of this form.  To ensure that we do not discriminate, we need to keep records. If you do not answer this question it will not affect your application in any way

 

 

 

 

 

Applicant 1

 

Applicant 2

Please state which of the following describes your ethnic origin:  White British, White Irish, Asian or Asian British, Black or Black British, Mixed ethnic background, Other (please specify)

 

 

 

 

Employment

 

Applicant 1

 

Applicant 2

Are you employed or

self-employed?

 

 

If self employed, what is your trade or profession?  (please ignore the rest of this section)

 

 

If employed what is your job title?

 

 

Are you permanently employed?

 

 

Are you on a fixed term contract?

 

 

 

Employment (continued)

 

Applicant 1

 

Applicant 2

Employer’s name

 

 

 

Employer’s address

 

 

 

 

 

 

 

Employer’s telephone no.

 

 

 

How long have you worked for your current employer?

 

 

 

 

Type of tenure

Details of the two forms of housing we propose to build at Little Bickington Farm are contained in the leaflet “Affordable Housing the High Bickington Way” and in the two examples which are enclosed with this form. This information is briefly summarised below.

 

Equity Purchase  In this model you would need to obtain your own mortgage for a sum agreed between us within a range of 40% to 80% of the market value of the house you wish to purchase.  The balance would be in the form of a ‘Second Mortgage’ provided by the CPT.  Whilst you will not have to make monthly payments, in relation to the ‘Second Mortgage’, you would, at any time in the future when the property is resold, need to repay the CPT’s mortgage together with an agreed share of any ‘uplift’ in the Market Value achieved during the time that you have owned the property.

 

Tenancy Plus  In this model you do not buy the property but pay a monthly rent to the CPT. When you leave the property, the CPT may be able, subject to a number of conditions, to make you a payment linked to the amount of rent you have paid less the costs incurred by the CPT in providing and maintaining the property throughout the life of the tenancy.

 

The following properties may be available for rental, please indicate your property choice

Property Details

No of persons

Approx Monthly Rent

Property Choice

 

 

(excl Council Tax)

 

 

 

 

2 bedroom 2nd floor flat

 

£396.00

 

3 bedroom 2nd floor flat

 

£476.00

 

 

The following property may be available for equity share together with the percentage share you may wish to purchase.

 

Property Details

No of persons

Market Value

% Share of Market Value

 

 

 

 

 

 

3 bedroom mid terraced house (x3)

 

£157,500

 

 

Financial information

 

The choice of tenure that will best suit you will depend on how much savings you have and what monthly payments (either rent or mortgage) you can afford.

 

We therefore need to ask about your combined income, savings and outgoings.  If you prefer we could collect this information in a face-to-face interview.  Everything that you tell us will be treated in the strictest confidence.

 


I would prefer to give this information in a face-to-face interview.                 Yes                No

 

If you have answered ‘Yes’ someone from the Community Property Trust will be in touch with you shortly. Please turn to the last page and sign the form.

 

If you have answered ‘No’ please turn over and complete the remainder of this form.


 

Monthly Amount (£)

 

Type of Income

Applicant 1

 

Applicant 2

Work income (before tax)

 

 

 

Regular overtime income

 

 

 

Income Support

 

 

 

Child Benefit

 

 

 

Job Seekers Allowance

 

 

 

Tax Credits

 

 

 

State Pension

 

 

 

Works Pension

 

 

 

Widows Pension

 

 

 

Incapacity Benefit

 

 

 

Maintenance

 

 

 

Other – please state

 

 

 

Total Income (before tax)

 

 

 

Investments

 

 

 

Amount of Savings

 

 

 

Current Property Value if owned

 

 

 

Amount Outstanding on Mortgage

 

 

 

Monthly Mortgage repayments

 

 

 

Amount Outstanding on Secured Loans

 

 

 

Monthly Loan Repayments

 

 

 

Credit Card amount(s) Outstanding

 

 

 

Monthly Credit Card Repayments

 

 

 

Please tick if you are in receipt of Housing Benefit

 

 

Please tick if you are in receipt of Council Tax Benefit

 

 

 

 

 

Signatures

 

Please check that you have filled in all relevant sections (otherwise the form may have to be returned to you) and then sign and date the form in the spaces below.

“I declare that to the best of my knowledge all the information given on this form is correct.”

 

 

 

Signed

 

 

Date

 

First Applicant

 

 

 

 

Second Applicant

 

 

 

 

 

Data Protection Act 1998

 

All the information you give us on this form will be held either on computer or in a manual file by High Bickington CPT Ltd and is protected by the provisions of the Data Protection Act 1998.  It will be used purely in connection with your application for housing and some of it may be disclosed to other agencies working in partnership with High Bickington CPT Ltd (such as Torridge District Council, Devon and Cornwall Housing Association).  By signing this form you are agreeing to the processing of your data in accordance with the Data Protection Act 1998

 

 

Equal Opportunities

 

High Bickington CPT Ltd is committed to an Equal Opportunities policy for all.  We do not discriminate on the grounds of race, colour, ethnic or national origin, religion, sexual orientation, marital status or age, either as an employer or as a service provider.