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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
Please enter your postcode in the box below, including the space, ie RH8 0BT, and click the 'Show Postcode Addresses' button and select your address.
Postcode
Address
Telephone
Name of disabled person
Address of disabled person if different from above
Please enter your postcode in the box below, including the space, ie RH8 0BT, and click the 'Show Postcode Addresses' button and select your address.
Postcode
Address
Does the disabled person usually live here
Yes
No
Page 2
Grounds for application
Is there a second bathroom or kitchen required for meeting the needs of the disabled person
Yes
No
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
Yes
No
Is there a wheelchair used indoors by the disabled person
Yes
No
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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