Transfer Application Form Louth County Council
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Transfer Application Form Louth County Council 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 / Dromiskin Carlingford / Omeath / Greenore Knockbridge ARDEE MUNICIPAL DISTRICT Ardee Castlebellingham / Kilsaran Collon Dunleer / Tinure Louth Village Tallanstown DROGHEDA BOROUGH DISTRICT Drogheda North Drogheda South Clogherhead Termonfeckin 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 .