South Dublin County Council

APPLICATION FORM FOR

SOUTH DUBLIN COUNTY COUNCIL

RENTAL ACCOMMODATION SCHEME

Applicant’s Name:
Applicant’s Address:

PLEASE RETURN COMPLETED FORM TO:

RENTAL ACCOMMODATION SCHEME,

HOUSING DEPARTMENT,

COUNTY HALL,

TOWN CENTRE,

TALLAGHT,

DUBLIN 24.

Telephone:01-4149358

Fax:01-4149107

Please read this section carefully

Can I apply?

 TO APPLY FOR THIS SCHEME YOU MUST HAVE CLAIMED RENT SUPPLEMENT FOR THE LAST 18 MONTHS AND SUBMIT PROOF OF THIS WITH YOUR APPLICATION.

 If you are from outside the European Union you must have permission to stay in Ireland and have a Stamp 4 card for all members of your family aged 16 or over.

 The Rental Accommodation Scheme has an Estate Management Policy. This means that the background and history of anyone applying for the Rental Accommodation Scheme will be examined. The details of this policy are given on the last sheet of this form.

How do I apply?

 Please answer all the questions on this form. If it is incomplete or if questions are not answered correctly, you may be considered ineligible for the Rental Accommodation Scheme.

 Please make sure PPS numbers are given for all the people who live with you.

 Incomplete applications will be returned.

What happens then?

 Provided you are eligible we will contact your current landlord to confirm his/her interest in the scheme.

 If the landlord is interested we will arrange to have the property inspected by an Environmental Health Officer.

 On completion of the property inspection, we will negotiate terms with the landlord.

 Finally on completion of negotiations, we will invite the tenant to the Council Offices, to sign contracts.

 If the landlord is not interested in the scheme you will be placed on a pending list until suitable, alternative accommodation has been sourced for you.

Section 1:Your Details

Name: ______

Address: ______

______

P.P.S.N: ______Date Of Birth: ___/____/_____

Home Phone: ______Mobile: ______

Nationality: ______

Are you on South Dublin County Councils Housing list? YES / NO

If YES, what is your reference number? ______

Section 2: Your Household Details

Full Name / P.P.S.N. / Date of Birth / Nationality / Relationship to you (Son, Daughter, Partner etc.)

If your household includes people who are not European Citizens and are over 16 do all of these people have a Stamp 4 card? YES / NO

Do you or any members of your household have any special needs? YES \ NO

If YES please explain requirements ______

______

Section 3:Your Address History

Current Landlord’s Name: ______

Landlord’s Address:______

______

Landlord’s Contact Number: ______

Property Type (House, Apartment etc):______

Number of Bedrooms:______

Total Rent Paid to Landlord:€______per month

Please give details of where you have lived in the last 5 years

Address / Dates / Landlord Name & Contact Number / Reason for Leaving

*Other addresses may be written on the back of this form*

Have you previously owned a property or site/do you currently own a property or site?

Previously YES / NOCurrently YES/NO

If yes please give details

______

Have you ever had your own local authority tenancy?YES /NO

If the answer is YES, please complete;

Address: ______

Name of Local Authority: ______

Date you left: ___/____ /___Reason for leaving: ______

______

Section 4: Your Background

Have you or someone living with you ever been arrested, or are there any charges pending in relation to a crime or anti social behaviour? YES/NO

If the answer is YES, please give details and dates:

______

Along with your application you MUST provide the following information:

Income details – receipt showing social welfare payments, payslip etc. for all family members in receipt of an income.
Receipt showing how much Rent Supplement you are being paid.
Proof you are receiving Rent Allowance for over 18 months. This may be obtained from your CWO.
If you are from outside the European Union you must provide a copy of Stamp 4 card for all members of your family over the age of 16.
You must provide a PPSN for all those named on your application.
You must have the Revenue Letter on Appendix 1 attached completed by all applicants.

Details:

RAS will give you long-term housing security.
South Dublin County Council will make agreements with landlords directly.
You will transfer to RAS in your current accommodation providing all the criteria are met. Otherwise you will be placed on a waiting list until suitable accommodation becomes available.
Inspections will take place to ensure that high quality accommodation is provided.
Any changes in contact details must be notified to the RAS Unit as soon as possible.

Once you are signed up to the Rental Accommodation Scheme:

SDCC will pay the rent to the landlord directly.
SDCC will provide you with an An Post payment card in order to pay your rent contribution. Your tenant contribution will no longer be paid to your landlord.
Your rent to SDCC will be approximately 10% of total household income (differential rent).
You may take up employment and remain on the scheme.

I have given honest answers. I am aware that if I have given dishonest answers my application will not be considered any further. South Dublin County Council will check the answers I have given.

I authorise South Dublin County Council to make whatever enquiries it deems necessary to verify this information. I accept that it is an offence to give false or misleading information.

Signed:

Applicant 1:______Date: ___/___/___

Applicant 2:______Date: ___/___/___

Estate Management Policy

It is the policy of South Dublin County Council that applicants who apply to them for accommodation and who are being considered for a letting will have their application considered on Estate Management grounds before a letting is finally made in accordance with Section 14 (1) and 15 (2) of the Housing (Miscellaneous Provisions) Act, 1997.

Section 14 of the housing (Miscellaneous Provisions) act 1997, provides that a housing authority may refuse to make or defer the making of a letting to a person where; -

(1) The authority considers that the person is or has been engaged in anti-social behaviour or that a letting to that person would not be in the interest of good estate management.

(2) The person fails to provide information relating to persons residing with that person, which is requested by the Housing Authority and which the Authority considers necessary in connection with an application for letting.

Section 15 (2) of the Housing (Miscellaneous Provisions Act 1997, also provides that a Housing Authority may request from another Housing Authority, the Garda Siochána, Department of Social Welfare, information in relation to any person seeking a letting from the Housing Authority.

In addition, South Dublin County Council may contact current or past landlords for references, and may take these references into account when considering an application.

IMPORTANT – THIS FORM MUST BE COMPLETED BY YOU AND CERTIFIED BY THE INSPECTOR OF TAXES BEFORE YOU RETURN SAME WITH YOUR COMPLETED APPLICATION FORM TO SOUTH DUBLIN COUNTY COUNCIL

A 1. Your full name: ______

TO BE COMPLETED

BY APPLICANT: 2. Your previous name: (if any) ______

Please use block

capital letters 3. Present address: ______

______

4. Previous address: (if any) ______

OFFICIAL

STAMP

5. Income tax reference number: ______

TO BE COMPLETED BY INSPECTOR OF TAXES

I hereby certify, in accordance with my records and to the best of my knowledge, that the above named person has not previously claimed income tax relief in respect of interest paid on money borrowed to purchase/build a dwelling.

DATE: ______SIGNED:______

B 1. Your full name: ______

TO BE COMPLETED

BY PARTNER/

SPOUSE 2. Your previous name: (if any) ______

Please use block

Capital letters 3. Present address:______

______

4. Previous address (if any) ______

OFFICIAL

STAMP

______

5. Income tax reference number: ______

TO BE COMPLETED BY INSPECTOR OF TAXES

DATE: ______SIGNED: ______