Discretionary Housing Payments Application
Discretionary Housing Payments are from a separate fund with a limited budget and are awarded as a short-term measure to help claimants in extremely difficult circumstances. To help us decide on your case, we need you to fill in this form, giving details of your income and spending.
Your Contact Details
 Name
 Address
 Telephone Number
Type of Help Required
 Would you like help with your Council Tax?
 Would you like help with your Rent?
 Would you like help with your Rent Deposit?
 Would you like help with your Rent in Advance?
 How long do you need this help for?
NOTE – This is a short term payment which would normally not exceed 26 weeks.
 What date do you wish the payment to start?
Rent Deposit
 How much is required for your deposit?
 Are you due to have a deposit or rent in advance in respect of your current tenancy returned to you?

 Have you now or in the past received assistance through a rent deposit guarantee scheme or anything similar?

Rent in Advance
 What will be the full contractual rent of the property you are intending to move to?
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