SaCha

Please complete the form below to apply.

Please answer all questions as accurately as posible
All questions marked with (*) must be supplied.

Your Details

* Surname

* First Names

* Title

Mr Mrs Miss Ms

* Sex

Male Female

Do you use or are you known by any other names?

(If 'YES' please state what they are)

Daytime No.

Evening No.

Mobile No.

* Email Address

Email Address (Confirm)

Current Home Address

* Address

* City / Town

* Postcode

* When did you move in?

DD / MM / YYYY

Correspondence Address (if different from above)

Address

City / Town

Postcode

Please tell us why you would like us to write to this address

Your Current Employer

Company Name

Address

City / Town

Postcode

Phone No.

Fax No.

Your current salary (£)

Work Email Address

Contact Name

Are you, or anyone residing with you:

Key Worker Ex / Currently Serving / MOD Other

If 'Other', please specify

Property Requirements

* Property Size Required

* What are you applying for?

Your Previous Addresses

If different from your current address, please give the most recent address first

Address 1

Full Address

Date From

DD / MM / YYYY

Date To

Type of Landlord

Private Council

Type of position

Tenant Lodger Owner

Reason for leaving

Address 2

Full Address

Date From

DD / MM / YYYY

Date To

DD / MM / YYYY

Type of Landlord

Private Council

Type of Position

Tenant Lodger Owner

Reason for leaving

Partner Details

Please answer the following questions for your partner or the other person applying with you (unless the person is under 18). You will need to provice proof of the identity of the people listed here.

Surname

First Names

Title

Mr Mrs Miss Ms

Sex

Male Female

Date of Birth

DD / MM / YYYY

What is their relationship to you?

Will they be a joint tenant?

No Yes

Your Partner's Previous Address

Please give their most recent address first

Address 1

Full Address

Date From

DD / MM / YYYY

Date To

DD / MM / YYYY

Type of Landlord

Private Council

Type of Position

Tenant Lodger Owner

Reason for Leaving

Address 2

Full Address

Date From

DD / MM / YYYY

Date To

DD / MM / YYYY

Type of Landlord

Private Council

Type of Position

Tenant Lodger Owner

Reason for Leaving

Other Peoples Details

Please answer the following questions for the other people you want to live with you

Person 1

Surname

First Names

Title

Mr Mrs Miss Ms

Sex

Male Female

Date of Birth

DD / MM / YYYY

With is Their Relationship to You?

Will They be a Joint Tenant?

No Yes

If this person is not living with you now but will be moving with you then please enter their current address below

Current Full Address

Person 2

Surname

First Names

Title

Mr Mrs Miss Ms

Sex

Male Female

Date of Birth

DD / MM / YYYY

What is Their Relationship to You?

Will They be a Joint Tenant?

No Yes

If this person is not living with you now but will be moving with you then please enter their current address below

Current Full Address

Person 3

Surname

First Names

Title

Mr Mrs Miss Ms

Sex

Male Female

Date of Birth

What is Their Relationship to You?

Will They be a Joint Tenant?

No Yes

If this person is not living with you now but will be moving with you then please enter their current address below

Current Full Address

Medical Conditions

If you, or someone moving with you, has a disability or health condition that affects the location or type of housing you need please give their details here

Surname

First Names

Surname

First Names

Surname

First Names

About Where You Currently Live

* Is the Property

Privately Owned Housing Association Council Other

Other: Please Specify

* What Type of Property do You Live In?

* Number of Beds

1 2 3 4

Other: Please Specify

Equal Opportunities

* How Would You Describe Yourself?

Please Specify

Income and Savings

* First Applicant * Second Applicant

Do you have access to at least £1,500 to cover the cost of moving and legal fees? Stamp duty (if applicable) is not included in this amount

No Yes

What is your total annual income before deductions? (Excluse overtime and bonuses but include pensions)

( £ )

How much overtime, bonuses and commission do you normally earn (in total) in a year?

( £ )

What are your savings?

( £ )

Have you been in rent arrears in the last 12 months?

No Yes

Do you have any outstanding loans?

No Yes

If yes, what is your total monthly payment?

What are the repayments for? (e.g. Car loan, etc.)

When is your final payment due?

DD / MM / YYYY

Do you have any outstanding credit cards?

No Yes

If yes, how much is the outstanding balance?

( £ )

When is your final payment due?

DD / MM / YYYY

Dop you have regular monthly financial commitments? (For example, child maintenance)

No Yes

If yes, specify how much you pay per month and the reason

( £ )

Reason

Are you in receipt of any benefits

No Yes

If yes, specify the type and how much you receive per month

Type

Per month

( £ )

Working Tax Credits

( £ )

Child Tax Credits

( £ )

Child Benefit

( £ )

Disability Living Allowance

( £ )

Guaranteed Maintenance Income

( £ )

Other (please state type and amount)

Type

Amount ( £ )

Have you ever had a home repossesed?

No Yes

Have you ever been declared bankrupt?

No Yes

If yes, has this been discharged?

No Yes

Have you ever had any county court judgements? (CCJs)

No Yes

If yes, have they been satisfied?

No Yes

Have you ever defaulted on a loan?

No Yes

Have you ever been refused a mortgage?

No Yes

Are you currently in an IVA (Individual Voluntary Arrangement)?

No Yes

Other Relevant Information

Please use the space below to provide any extra information that may help your application

References

If you have any references in electronic format please use the areas below to upload them (please only supply .pdf or .jpg formats)

Please ensure the files are no larger than 1Mb per file

Confirmation

I confirm that the information entered in this form is accurate to the best of my knowledge

Confirm

I confirm thay I've read and agree to the Disclaimer and Privacy policy

Confirm

IMPORTANT

Your application and answers supplied will not be checked or validated before submission. It is your responsibility to ensure the information provided is correct and accurate. Submitting an application with incorrect or inaccurate answers may have a detrimental affect on your application.