PREVENTION OF HOMELESSNESS APPLICATION FORM

Priority for “Prevention of Homelessness” is awarded at Silver level.

A Silver priority pass will be issued to persons assessed by either Council (SBC) or BHA as being threatened with homelessness. Examples of this include, but are not limited to:

 Relationship breakdown (non-BHA tenants)  Living in an insecure tenancy such as tied accommodation or having a Short Assured Tenancy which is coming to an end within 2-6 months  Having a relationship breakdown with parents or another occupant of the home  Having financial difficulties in making rent or mortgage payments within the current home  Is living in a mobile home (not static)

In order to assess your Prevention of Homelessness Priority application, please complete form in full.

APPLICATION: Homehunt Registration Number ______

Your Name ______

Your Address ______

Telephone: Home ______Work ______Mobile ______

Prevention of Homelessness

Have you/are you

 had a relationship breakdown and are a non-BHA tenant? Yes No

if Yes, please give details of your relationship ______

 living in an insecure tenancy such as tied accommodation Yes No or having a Short Assured Tenancy which is coming to an end within 2-6 months?

if “Yes”, please give details of your tenancy tenure ______

 had a relationship breakdown with parents or another Yes No occupant of the home?

if “Yes”, please give details of your relationship breakdown ______

 having financial difficulties in making rent or mortgage Yes No payments within the current home?

if “Yes”, please give details of your financial situation ______

 living in a mobile home (not static)? Yes No

if “Yes”, please give details of your financial situation ______

Please sign here ______Date ______

I confirm that the information I have given is correct and that I have not supplied any false or misleading information, or withheld any relevant information. I agree to the use of this information in accordance with the data protection notice as stated in the ‘ Housing Association Guide’ booklet.

Note: You can list specific locations or tell us a wider area which you would consider. We may contact you to discuss suitable locations when assessing your priority.

PLEASE TICK WHICH AREAS YOU WOULD LIKE YOUR PRIORITY TO COVER You must apply for ALL suitable properties in the areas chosen or your priority will be removed after six months (please see the BHA Guide Booklet for more information about your priority)

Coldstream Area Duns Area Area Eyemouth Area (contd) Allanton Ayton Hutton Eccles Cranshaws Lower Gordon Duns Eyemouth Deanhead Paxton Gavinton Eyemouth Gunsgreen Reston Hume Eyemouth Old Town St. Abbs Preston Foulden Upper Burnmouth Swinton Westruther

Sheltered Housing Developments If you have indicated a sheltered Housing Requirement on your registration form, please tick to choose the Developments you wish your pass to apply to:

Coldstream, Gowanlea Court Duns, Boston Court Eyemouth, Linkim Court