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Please visit VictoriaForms.com/VF-Creator/ to start creating online forms in Word. Council Tax CHANGE OF ADDRESS FORM

Account reference Property reference

Full Name DOB if between 16 & 18 years old

Moving from:

Date of move Is the property empty of furniture? Tenancy end date Sale completion date

Name and address of new owner of property

Name and address of the Landlord Name and address of Managing Agent

Moving to

Are you responsible for payment of Council Tax at this address? Moving in date Date furnished Tenancy start date Sale completion date SPD form required? Transfer DD to the new account?

Set up DD? Sort Code Account No Payment day Account holder(s) 1st, 15th, 25th Additional information

Telephone no Email Info provided by Date Form completed Date by

Single Person Discount If you are the only adult aged 18 or over living in the property, you are entitled to a 25% discount. If you wish to claim this discount please sign the following statement: I declare that I am the only adult aged 18 or over living in this property. I understand that if my circumstances change (i.e. another adult moves or someone already resident becomes 18) I must notify the Council Tax Section within 21 days of the change occurring.

Signature Date

Name in full

Other Discounts The full Council Tax bill assumes there are 2 adults living in a dwelling. However some adults are disregarded for Council Tax Purposes. If all but 1 are disregarded you may be entitled to a discount. Please complete the following: How many adults aged over 18 live here? Do any of the adults fall into the following categories? Please state the number of adults falling into each relevant category Student/Student Nurse Youth Trainee/Apprentice Severely Mentally Impaired In receipt of Child Benefit School Leaver (age 18-20) In Prison or otherwise Detained Patient in a Home or Hospital Resident Carer Other (please state) The appropriate form(s) will be sent to you shortly. Reduction for Disability If a qualifying individual defined as “A person who is substantially and permanently disabled (whether by illness, injury, congenital deformity or otherwise) resides in the property and one of the following is provided, a reduction for disability may be applied for: 1. A room which is not a bathroom, kitchen or a lavatory and which is predominantly used and is required to meet the needs of the ‘disabled’ resident 2. A bathroom or kitchen which is not the only bathroom or kitchen in the dwelling which is required for meeting the needs of any ‘disabled’ resident 3. Sufficient floor space to permit the use of a wheelchair required for meeting the needs of the ‘disabled’ person Please tick this box if you believe you may qualify for this reduction and a form will be sent to you. Council Tax Benefit If you are on a low income or wage you may qualify for Council Tax Benefit. Please tick this box if you wish to be sent an application form Other Changes I wish to tell you about other changes that may affect my Council Tax, i.e. change of name etc:

Declaration I understand that I may be liable to penalties if I provide false information. I also understand that if my circumstances change that I am legally obliged to notify the Council Tax Section within 21 days of the change. I also understand that the Council, in order to protect public funds, may use the information provided on this form to prevent and detect fraud. The Council may also share this information for the same purpose with other organisations that handle public funds.

Signature Date Name in Daytime full phone number