Tandridge District Council Forms

Council Tax application for reduction for a person with a disability

Page 1

Please ensure that you have read and understood the notes relating to this form before completing.

Only people who are liable to pay Council Tax can apply.

Billing number

Name of Applicant

Applicant's address

Address search

Address

Telephone

Name of disabled person

Address of disabled person if different from above

Address search

Address

Does the disabled person usually live here

YesNo

Page 2

Grounds for application

Is there a second bathroom or kitchen required for meeting the needs of the disabled person

YesNo

Is there a room (other than a bathroom or kitchen ) which is predominantly used by and required for meeting the needs of the disabled person

YesNo

Is there a wheelchair used indoors by the disabled person

YesNo

Date from which reduction should apply

Declaration

The information given on this form is correct. I will notify you immediately if I think that I may no longer be eligible for a reduction granted in respect of this application.

I confirm that I have read and understood the statement above

Yes

Name of person completing this form

E-mail address

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