Immediately available homes application This form is for adults aged 50+ or 60+ (they can have children who are 18 or above). These are properties which are often hard to let and have already been advertised by Chelmsford City Council and CHP unsuccessfully. When a property becomes available, the shortlist is based on priority date. Once complete, please return this form to: Myriad House, 33 Springfield Lyons Approach, Chelmsford, Essex. CM2 5LB. Or email
[email protected]. If you do not have access to the internet or would like assistance you can contact the Customer Service Centre on 0300 555 0500. We need this information in order to enter into a contract with you as well as to satisfy our legal obligations to understand and assess your housing needs. By filling out this form, you are helping us assess your housing needs, please see www.chp.org.uk/privacy for more information on how we look after your data. 1. Household details Starting with yourself, please provide details of everyone currently living in your household. Title: First name: Surname: Relationship to applicant Date of birth: 2. Details of current accommodation Current address (including postcode): Home telephone: Mobile telephone: Email: Date moved in: Owned/rented: Property type (e.g one bed flat): Local Authority: Landlord: 1 If you have lived at your current address for less than five years, please give your previous addresses for the last five years: Address (include postcode): Date moved Date moved Landlord: Reason for leaving: in: out: Do you currently own, any other property here or abroad? Yes No If yes, please state address: Is this property subject to be sold Yes No What is the main reason for wanting to move from your last settled home? Do you have any pets that you would want to live with you? Yes No If yes, please provide details: 3.