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For office use only Application Date: / /

Application No.

Input date

Vale of White Horse District Council Open Market Equity Loan Scheme

Supplementary Sheet

First Name Surname

APPLICANT: …….……………………….. ………………………….……

JOINT APPLICANT: ………………………………. ……………………………….

The District Council Equity Loan Scheme is designed to assist households who are unable to purchase on the open market. To be considered for this scheme, kindly complete the form carefully and answer all the sections. Please use a black pen and write in capital letters. If any of the questions do not apply to you, please mark N/A for not applicable. If you do not complete all the sections, or fail to provide copies of the documents required you may find that your application cannot be registered.

It is important that you notify Vale of White Horse District Council in future if there is any change in your circumstances.

VoWH CHR Application Form 01 October 2012 A. PERSONAL DETAILS

If you are making a joint application, please provide details of yourself and the joint applicant.

Applicant Joint applicant Mr Mrs Miss Ms Mr Mrs Miss Ms Surname: First Name (s): Address: (if different)

Post Code: Home Tel: Work Tel: Ext: Mobile Tel: E-mail: Date moved to this address

Correspondence address, if different ______

Applicant Joint Applicant

Single Separated Single Separated Married Living Together Married Living Together

Have you, or anyone to be housed with you, ever been known by a different name (including a ‘maiden’ name)?

If yes, please provide details:

Name Previous Name

VoWH CHR Application Form 01 October 2012 B. ELIGIBILITY

Under the Asylum & Immigration Act 1996 it is necessary to ask you the following questions: Applicant Joint Applicant

Are you a British Citizen? Yes / No Yes / No

Have you lived in the UK for the last 5 years? Yes / No Yes / No

If no, when did you move to the UK? ……………………………………………………………..

Are you, or anyone on the application, subject to any immigration rules? Yes / No

If you, or anyone else on the application, is not a British Citizen, please state their current immigration status, and provide a copy of their current passport and visa? …………………………………………………………………………………………………………

If you need a translator, what is your first language?......

Have you, or anyone to be housed with you, ever been served with notice, or had a court order, or injunction, for anti-social behaviour? Yes / No

If yes, please give full details, including dates and types of order, and whether they are still in effect: ………………………………………………………………………………………… ………………………………………………………………………………………………………… …………………………………………………………………………………………………………

8. Have you, or anyone to be housed with you, ever been served with notice, or had a court order, for rent arrears? Yes / No

If yes, please give full details, including dates and types of order, amounts, and whether they are still outstanding: ………………………………………………………………………… …………………………………………………………………………………………………………

C. YOUR PRESENT HOME

1. What type of property is your present home? Please tick

House Mobile Home/ Caravan Bungalow Prison Flat Hospital Maisonette Room in shared house Bedsit No Fixed Address

Other, please specify……………………………...... ……………………………………………………………………..

2. How many bedrooms does your property have?

3. Please give approximate bedroom sizes (in feet and inches eg 9’6” x 8’9”)

Bedroom 1 x Bedroom 2 x Bedroom 3 x Bedroom 4 x

VoWH CHR Application Form 01 October 2012 D. ADDITIONAL INFORMATION

1. Please provide the following details if you or your partner are / were members of the Armed Forces

Applicant Joint Applicant Date of enlistment Date of Discharge Date of expiry of Notice to vacate MOD property. Length of residence in the Vale of White Horse District prior to enlistment Address of former residence in the Vale of White Horse Do you have employment in the Vale of White Horse District (or a job offer in Vale District), if yes, please give employer’s contact details.

2. Have you applied for housing in the Vale of White Horse District before? Yes/ No

If yes, approximately when did you apply ………………

3. Are you or anyone to be housed with you, a Vale of White Horse District Council employee, or an employee or Board member of Sovereign Vale / Catalyst Housing or any other housing association in the Vale of White Horse Partnership. If yes, please provide details:

Name of person

Your relationship to them

Name of the organization

4. Are you or anyone to be housed with you, closely related to a Vale of White Horse District employee, or an employee or Board member of Sovereign Vale/ Catalyst Housing or any other Housing association in the Vale of White Horse Partnership. If yes, please provide details:

Name of person

Your relationship to them

Name of the organization

VoWH CHR Application Form 01 October 2012 E. LOCAL CONNECTION

Some of the housing developments are subject to a local connection criteria. This means that they must be let to a person with a specified local connection. If you have a local connection to ANY parish in the district, please give details here. You should indicate addresses and dates for previous and current residence, employment, and close family members (and their addresses).

Please list parishes where you or the joint applicant have a local connection, and state what your connection is (there is a map of local parishes on the last page):

Work Parent/child Parish Name Live/lived here there lives there

a) Lived in the parish for 5 out of the last 8 years b) Been employed full time in the parish for the last 2 years

Employer’s name & Full-time Part-time Voluntary Date address (state employment hours) started

c) Close relatives (parent or child of applicant or joint applicant) who have lived in the parish for the last 10 years

Name Address Relationship Years in parish to you (from & to)

VoWH CHR Application Form 01 October 2012 F. WHERE YOU WOULD LIKE TO BE HOUSED

Abingdon Kennington Appleford Kingston Bagpiuze Appleton with Eaton Ashbury Littleworth Besseleigh Lockinge Bourton Buckland Lyford Charney Basset Milton Heights Chilton Pusey Coleshill Drayton Eaton Sparsholt Standford in the Vale East Steventon Uffington Upton Fyfield Grove Harwell Woolstone Wootton

VoWH CHR Application Form 01 October 2012

VoWH CHR Application Form 01 October 2012