Application for Discretionary Housing Payment

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.










Reason for DHP application 


If this is a second application, what steps have you taken to improve your situation since you last claimed DHP. Please provide evidence such as properties or jobs that you have applied for



We may pay up to £100 costs. Please upload a letter from the removal firm stating their costs and bank details so that we can make any payments directly to them



£


£


















Evidence should be supplied with this to support your application

Disability information 






Capital



















Expenditure


Rent you pay (the amount not covered by benefit)


£


Council Tax you pay


£


Food, Toiletries & Cleaning Products


£


Internet/Broadband


£




£


Mobile

£


Personal Insurance

£


Home insurance 

£


Water rates

£




£


Gas

£




£


Electricity


£




£


Other household fuel


£




£


TV Licence

£




£


Maintenance / Child Support

£


Car - Petrol 

£


Car - Insurance

£


Car - Tax

£


Car - Maintenance

£


School dinners

£


Clothing / School Uniform

£


Childcare

£


Child Clubs

£


Public Transport

£


Other

£




£

Household Income


Armed Forces Independent Payment 

£


Attendance Allowance

£


Carer's Allowance 

£


Child Benefit

£


Child Tax Credits

£


Disability Living Allowance Care

£


Disability Living Allowance Mobility 

£


Employment Support Allowance

£


Housekeeping / money from people living with you

£


Incapacity Benefit

£


Income Support or Jobseeker's Allowance

£


Maintenance for yourself or a child

£


Pension Credit

£


Personal Independence Payment Daily Living

£


Personal Independence Payment Mobility

£


Private / Occupational pension

£


State retirement pension

£


Statutory Sick / Maternity Pay / Company Sick Pay

£


Wages / Salary - Net

£


Working Tax Credits

£


Universal Credit

£


Other income / benefits


£




£

Application for a rent top up








Please provide the following bank details as it appears on the account in case an award is successful



One off payment applications


If you have been served a section 21 notice please explain the reason for this and provide evidence of when this notice was issued.








Please refer to current Local Housing Allowance Rates.











Further Information

Please enter any additional information that may help to support your application. 

For example: if you have taken steps relating to the management of your debts please explain your action - contacted CAB etc

Evidence


We will need to see proof of the information you have provided for us in the form.


If you have not already provided a rent statement from when the arrears began up to date, please send to the address below.


If there is any evidence you cannot provide electronically, then please post it to Civic Centre, Castle Hill Avenue, Folkestone, Kent, CT20 2QY, United Kingdom.


Declaration





We will use the information you give in this form and any supporting evidence you send us, to process applications for Housing Benefit (including Discretionary Housing Payments) and Council Tax Reduction or to determine Council Tax liability.


We may pass the information to other internal council departments and external agencies or organisations such as the Department for Work and Pensions, the Jobcentre Plus and HM Revenue and Customs, as allowed by the law.