Transfer Application Form

1. Name Applicant 1 ______

Applicant 2 ______

2. Address ______

3. Date of Birth Applicant 1 _____/_____/______

Applicant 2 _____/_____/______

4. Telephone No. ( )______

5. Marital Status ______

6. Current Accommodation Details:

No. of Bedrooms

Please indicate your current type of accommodation: single storey □ two storey □

7. Have you previously applied to this Council for a transfer: Yes____ No____

Details of other Household Members residing in the house:

Name Age Gender M/F

Cuirfear fáilte roimh chomhfhreagras Gaeilge Transfer Application Form Louth County Council

8. Reason for requesting a Transfer (tick appropriate):

Overcrowding

Serious medical condition

Downsizing

Other exceptional circumstances- please provide details.

If application is in respect of serious medical condition please attach consultants report.

9. Area of Preference (please tick up to three areas):

DUNDALK MUNICIPAL DISTRICT

Dundalk Blackrock / Haggardstown / Carlingford / / Greenore

ARDEE MUNICIPAL DISTRICT

Ardee / Kilsaran / Tinure Louth Village

DROGHEDA BOROUGH DISTRICT

Drogheda North Drogheda South Tullyallen

10. Birth Certificates

Birth Certificates must be submitted for all household members

Cuirfear fáilte roimh chomhfhreagras Gaeilge Transfer Application Form Louth County Council

11. Public Order Offences

In the five years prior to the date of this application, has any member of the household been convicted of an offence under

Criminal Justice (Public Order Act) 1994 Yes____ No____ (Public Order offences)

Housing (Miscellaneous Provisions) Act 1997 Yes____ No____ (subject of an excluding order/ interim excluding order)

Criminal Justice Act 2006 Yes____ No____ (Failure to comply with a behaviour order)

Children Act 2001 Yes____ No____ (Failure to comply with a behaviour order)

Please note that before a Transfer Application can be considered, tenants must:

1. Have a clear rent account 2. Have no record of Anti-Social Behaviour 3. Have no current Written Warnings for any breach of the Tenancy Agreement 4. Existing dwelling must be surrendered in a satisfactory condition as determined by the Council 5. Be in the interest of good estate management

Please be informed that transfer applications may be refused due to

 Rent arrears, other debts or any monies owed in respect of any damage caused to a housing authority house  Unsatisfactory tenancy record  Engagement in anti-social behaviour  In the interest of good estate management

Declaration

I/We declare that the information and particulars given by me/us on this application are true and correct.

I/We authorise the housing authority to make whatever enquiries it considers necessary to verify details of my/our application which may include a request to An Garda Síochána.

Signed: ______Date: ______

Signed: ______Date: ______

Cuirfear fáilte roimh chomhfhreagras Gaeilge