Social housing form

Housing Register Qualification

Qualification Part 1 - Housing Needs
1a. Do you have a medical condition or disability that is made worse by your current home? *
No

1b. Do you have a medical condition or disability that means you cannot live in your home, or cannot access
part of it (e.g. cannot get up stairs, cannot access the bathroom)? *
No

1c. Do you have to leave your home due to regeneration, demolition, major repair, fire or flood, or because
your home has been assessed as unsafe by the Council? *
No

1d. Is your home overcrowded (i.e. you need more bedrooms than you have)? *
Yes

1e. Is your social housing property under-occupied (i.e. you have more bedrooms than you need)? *
No

1f. Are you homeless, or are you going to be homeless within the next 8 weeks? *
Yes

1g. Do you need to move because of harassment, domestic violence or other violence? *
No

1h. Have you succeeded to the tenancy of a social housing property in Gedling Borough Council that is not
suitable for your needs? *
No

1i. Are you in supported accommodation and ready to move on to your own tenancy? *
Yes

1j. Are you an approved foster carer who needs to move in order to foster children? *
No

1k. Are you a lodger with children who is sharing facilities (e.g. a kitchen, a bathroom) with other people who
are not in your household? *
No

1l. Are you experiencing hardship in your current home? (e.g. cannot afford the rent etc.) *
No

1m. Are you 50 or over and want to move into sheltered accommodation? *
No

1n. Are you disabled, with no children, and want to move into sheltered accommodation? *
No

Qualification Part 2 - Local Connection

2a. Have you lived in Gedling Borough Council consistently for the last 3 years? *
Yes

2b. Are you in paid work in Gedling Borough Council for at least 16 hours per week for at least 3 years? *
No

2c. Do you need to move to Gedling to support, or be supported by, a parent, sibling or adult child, for at least
3 hours every day who has lived in Gedling for at least the last 5 years? *
Yes
2d. Have been accepted by Gedling Borough Council under the homelessness legislation? *
Yes

2e. Have you been accepted by Gedling Borough Council for priority re-housing under a 'reciprocal
arrangement' with another council or social landlord? *
No

2f. Are you a care leaver or are you a former care leaver aged 25 or younger who has been placed in care as a
child in the Nottinghamshire County Council area? *
No

2g. Do you need to move as part of a police witness protection programme? *

No

2h. Did you have a local connection to Gedling (2a or 2b) before you were placed in temporary accommodation
by another council? *
Yes

2i. Did Gedling Borough Council place you in supported housing as part of the prevention/relief of your
homelessness? *
Yes

2j. Are you a social housing tenant who needs to move to Gedling Borough Council to take up an offer of
employment? *
No

2k. Are you serving in the regular Armed Forces, or have you served in the regular Armed Forces within the last
5 years? *
No

Housing Register Qualification - Result

You qualify for social housing

There is not enough social housing in ##LocalAuthorityName## to supply it for everyone who would like it.
We can only allocate social housing to people who need housing and have a local connection.

As you have answered Yes to at least one question from Part 1 and one question from Part 2, please continue to complete the
application form for social housing.

You do not qualify for Social Housing

There is not enough social housing in ##LocalAuthorityName## to supply it for everyone who would like it.
We can only allocate social housing to people who need housing and have a local connection.

If you have not answered Yes to at least one question from Part 1 and one question from Part 2, it is not likely that you will qualify
for social housing in ##LocalAuthorityName## ##LocalAuthorityIneligibilityLink##

Section A - Main Applicant

Primary Applicant

* next to a question means you must provide an answer to proceed.

Primary household member details
About Your Household
Title *
Mr

First name *
Mohamad Ramez

Surname *
Zeno

Has this person been known by any other names, e.g. a maiden name? *
No

If yes, please provide details

not entered

Date of birth *
24/04/1982

Gender *
Male

Have you ever been described as transgender? *

No

National Insurance number *

NJ075088A

Are you pregnant? *

No

If yes, please provide pregnancy due date

not entered

Home telephone number

07707356598

Mobile telephone
not entered

E-mail address
ramezzeno90@gmail.com

Employment Details

Are you currently in employment? *

No

Employer name
not entered

Employer address
not entered

Average number of hours worked per week

0

Average monthly wage after tax

0

Have been offered permanent full time work in Gedling Borough Council? *
No
Are you a social housing tenant wanting to move to be closer to employment or training? *
No

Equality Monitoring

To ensure that we are meeting the needs of all our applicants it is important that we ask you a few questions about yourself. This
information will be held securely and confidentially and, where appropriate, processed in compliance with the Data Protection Act
1998. We will not use this information to assess your housing priority. The information will be used to ensure our service is
accessible to the whole community and that we are taking their views and needs into account.

Do you consider yourself to have a disability? Disability can be described as any long-term illness, health problem or disability
which limits your daily activities or the work you can do, including problems that are due to old age.

Disability

Hearing Impairment
Learning Disability
Mental Illness
Other
Physical Disability
Speech Impairment
Visual Impairment

If 'Other', please state in the box

not entered

Ethnic Origin
Any other White background

Ethnic Origin Other

Swedish

Religion or Belief
Muslim

Sexual Orientation
Heterosexual

Connection to the UK

Are you From Abroad? *

Yes

Please select the reason you are eligible to be in the UK

e. Persons granted other protection leave

Nationality *
Other

Which EU country?
Sweden

Which Other country?

not entered

Are you subject to immigration control? *

No

If yes, please give details

not entered
Current Address Details

Current Address
NG5 2DA The Tudor House Hotel 336-344 Mansfield Road Nottingham
Date you moved in to this address:07/08/2023

Correspondence Address
Correspondence description:Home
The Tudor House Hotel 336-344 Mansfield Road Nottingham NG5 2DA

Section A - Joint Applicant

Additional household members

Please add any joint applicant or additional household members details using the buttons below.

Joint household member details

About Your Household

Title *
Ms

First name *
Khadija

Surname *
Alkharj

Has this person been known by any other names, e.g. a maiden name? *
No

If yes, please provide details

not entered

Date of birth *
01/11/1989

Gender *
Female

Have you ever been described as transgender? *

No

Relationship to main applicant

Wife

National Insurance number *

SW675878C

Is the joint applicant pregnant? *

No

If yes, please provide pregnancy due date

not entered

Home telephone number

+447707356598
Mobile telephone
not entered

E-mail address
not entered

Employment Details

Is the joint applicant currently in employment? *

No

Employer name
Trust motor

Employer address
51 Hungerhill Rd Nottingham NG3 3PN

Average number of hours worked per week

70

Average monthly wage after tax

665

Equality Monitoring

To ensure that we are meeting the needs of all our applicants it is important that we ask you a few questions about the joint
applicant. This information will be held securely and confidentially and, where appropriate, processed in compliance with the
Data Protection Act 1998. We will not use this information to assess your housing priority. The information will be used to ensure
our service is accessible to the whole community and that we are taking their views and needs into account.

Do they consider themselves to have a disability? Disability can be described as any long-term illness, health problem or disability
which limits your daily activities or the work you can do, including problems that are due to old age.

Disability

Hearing Impairment
Learning Disability
Mental Illness
Other
Physical Disability
Speech Impairment
Visual Impairment

If 'Other', please state in the box

not entered

Ethnic Origin
Any other ethnic group

Ethnic Origin Other

Swedish

Religion or Belief
Muslim

Sexual Orientation
Heterosexual

Connection to the UK
Is the joint applicant from abroad? *
No
Please select the reason the joint applicant is eligible to be in the UK
g. Other

Nationality *
Other

Which EU country?
Sweden

Which Other country?

not entered

Is the joint applicant subject to immigration control? *

No

If yes, please give details

not entered

Current Address Details

Current Address
NG5 2DA The Tudor House Hotel 336-344 Mansfield Road Nottingham
Date you moved in to this address:07/08/2023

Additional household member details

About Your Household
Title *
Mr

First name *
Ameer

Surname *
Zeno

Has this person been known by any other names, e.g. a maiden name? *
No

If yes, please provide details

not entered

Date of birth *
30/01/2010

Gender *
Male

Have you ever been described as transgender? *

No

Relationship to main applicant

Son

National Insurance number

not entered

Is this person pregnant? *

No

If yes, please provide pregnancy due date

not entered
Equality Monitoring

To ensure that we are meeting the needs of all our applicants it is important that we ask you a few questions about the
household members. This information will be held securely and confidentially and, where appropriate, processed in compliance
with the Data Protection Act 1998. We will not use this information to assess your housing priority. The information will be used
to ensure our service is accessible to the whole community and that we are taking their views and needs into account.

Do they consider themselves to have a disability? Disability can be described as any long-term illness, health problem or disability
which limits your daily activities or the work you can do, including problems that are due to old age.

Disability

Hearing Impairment
Learning Disability
Mental Illness
Other
Physical Disability
Speech Impairment
Visual Impairment

If 'Other', please state in the box

not entered

Connection to the UK

Please select the reason the applicant is eligible to be in the UK

g. Other

Nationality *
Non-EEA national

Which EU country?
not entered

Which other country?

not entered

Current Address Details

Current Address
NG5 2DA The Tudor House Hotel 336-344 Mansfield Road Nottingham
Date you moved in to this address:07/08/2023

Additional household member details

About Your Household
Title *
Mr

First name *
Abdullah

Surname *
Zrno

Has this person been known by any other names, e.g. a maiden name? *
No

If yes, please provide details

not entered
Date of birth *
01/01/2012

Gender *
Male

Have you ever been described as transgender? *

No

Relationship to main applicant

Son

National Insurance number

not entered

Is this person pregnant? *

No

If yes, please provide pregnancy due date

not entered

Equality Monitoring

To ensure that we are meeting the needs of all our applicants it is important that we ask you a few questions about the
household members. This information will be held securely and confidentially and, where appropriate, processed in compliance
with the Data Protection Act 1998. We will not use this information to assess your housing priority. The information will be used
to ensure our service is accessible to the whole community and that we are taking their views and needs into account.

Do they consider themselves to have a disability? Disability can be described as any long-term illness, health problem or disability
which limits your daily activities or the work you can do, including problems that are due to old age.

Disability

Hearing Impairment
Learning Disability
Mental Illness
Other
Physical Disability
Speech Impairment
Visual Impairment

If 'Other', please state in the box

not entered

Connection to the UK
Please select the reason the applicant is eligible to be in the UK
g. Other

Nationality *
Other

Which EU country?
Sweden

Which other country?

not entered

Current Address Details

Current Address
NG5 2DA The Tudor House Hotel 336-344 Mansfield Road Nottingham
Date you moved in to this address:07/08/2023
Additional household member details
About Your Household
Title *
Ms

First name *
Rima

Surname *
Zeno

Has this person been known by any other names, e.g. a maiden name? *
No

If yes, please provide details

not entered

Date of birth *
09/10/2015

Gender *
Female

Have you ever been described as transgender? *

No

Relationship to main applicant

Daughter

National Insurance number

not entered

Is this person pregnant? *

No

If yes, please provide pregnancy due date

not entered

Equality Monitoring

To ensure that we are meeting the needs of all our applicants it is important that we ask you a few questions about the
household members. This information will be held securely and confidentially and, where appropriate, processed in compliance
with the Data Protection Act 1998. We will not use this information to assess your housing priority. The information will be used
to ensure our service is accessible to the whole community and that we are taking their views and needs into account.

Do they consider themselves to have a disability? Disability can be described as any long-term illness, health problem or disability
which limits your daily activities or the work you can do, including problems that are due to old age.

Disability

Hearing Impairment
Learning Disability
Mental Illness
Other
Physical Disability
Speech Impairment
Visual Impairment

If 'Other', please state in the box

not entered
Connection to the UK

Please select the reason the applicant is eligible to be in the UK

g. Other

Nationality *
Other

Which EU country?
Sweden

Which other country?

not entered

Current Address Details

Current Address
NG5 2DA The Tudor House Hotel 336-344 Mansfield Road Nottingham
Date you moved in to this address:07/08/2023

Additional household member details

About Your Household
Title *
Ms

First name *
Sham

Surname *
Zeno

Has this person been known by any other names, e.g. a maiden name? *
No

If yes, please provide details

not entered

Date of birth *
13/10/2017

Gender *
Female

Have you ever been described as transgender? *

No

Relationship to main applicant

not selected

National Insurance number

not entered

Is this person pregnant? *

No

If yes, please provide pregnancy due date

not entered
Equality Monitoring

To ensure that we are meeting the needs of all our applicants it is important that we ask you a few questions about the
household members. This information will be held securely and confidentially and, where appropriate, processed in compliance
with the Data Protection Act 1998. We will not use this information to assess your housing priority. The information will be used
to ensure our service is accessible to the whole community and that we are taking their views and needs into account.

Do they consider themselves to have a disability? Disability can be described as any long-term illness, health problem or disability
which limits your daily activities or the work you can do, including problems that are due to old age.

Disability

Hearing Impairment
Learning Disability
Mental Illness
Other
Physical Disability
Speech Impairment
Visual Impairment

If 'Other', please state in the box

not entered

Connection to the UK
Please select the reason the applicant is eligible to be in the UK
g. Other

Nationality *
Other

Which EU country?
Sweden

Which other country?

not entered

Current Address Details

Current Address
NG5 2DA The Tudor House Hotel 336-344 Mansfield Road Nottingham
Date you moved in to this address:07/08/2023

Section A - Past Addresses

Address history

1 Mr Mohamad Ramez Zeno (Primary applicant)

Current address Date lived at address
The Tudor House Hotel 336-344 Mansfield Road Nottingham NG5 2DA 07/08/2023 to Present

Previous address Date lived at address

9 Cliff Road Carlton Nottinghamshire NG4 1BS Gedling 01/02/2020 to 07/08/2023

Grönelundsgatan 9b falköping FL9 9FL Out of Area - Gedling South 11/11/2013 to 01/02/2020

2 Ms Khadija Alkharj (Joint applicant)

Current address Date lived at address
The Tudor House Hotel 336-344 Mansfield Road Nottingham NG5 2DA 07/08/2023 to Present
 Previous address Date lived at address

9 Cliff Road Carlton Nottinghamshire NG4 1BS Gedling 01/02/2020 to 07/08/2023

Grönelundsgatan 9b falköping FL9 9FL Out of Area - Gedling South 11/11/2013 to 01/02/2020

Section B - Local Connection

Gedling Local Connection

Please tell us what your local connection to Gedling is. When we say 'you', we also mean the joint applicant, if any, such as your
partner.

Have you lived in Gedling Borough Council consistently for the last 3 years? *
Yes

Are you in paid work in Gedling Borough Council for at least 16 hours per week for at least 3 years? *
No

Do you need to move to Gedling to support, or be supported by, a parent, sibling or adult child, for at least 3
hours every day who has lived in Gedling for at least the last 5 years? *
No

Please provide further details

not entered

Section C - General Information

General Information

We are committed to ensuring that everyone seeking housing is able to fully take part in Homesearch. We are monitoring
whether people seeking housing may require additional support to take part in Homesearch, and/or to live independently. This
will make sure that we develop appropriate support.

Do you need any support to take part in Homesearch? (for example, help from local authority staff) *
No

If yes, please give details

not entered

Do you want to nominate someone to act on your behalf in Homesearch? For example a family member, a
friend or a support worker *
No

If yes, please give their name and contact phone number

not entered

Is there any reason why you, or anyone who needs to be rehoused with you, may need additional support to
live independently? *
No

If yes, please give details of why you require additional support, and what type of support you would need (for
example, help to pay bills, manage your finances, prepare food, shop or to maintain contact with family or
friends)
not entered

Are you or a member of your household currently being supported by anyone? *

No
Please give the support workers name, the organisation they work for and their contact details. This could
include your GP, Social Worker, Counsellor, Probation Officer etc. Please confirm who is being supported
not entered

Do you have pets?

No

If yes please give details of the type and number of pets

not entered

Is any member of your household a council employee, an employee or board member of a participating
housing provider or a councillor? *
No

If yes please give details

not entered

Section C - General Accommodation

Information
General Accommodation Information

Do both the main and the joint applicant live at the same address? *
Yes

If no please give details as to why either applicant lives at different addresses

not entered

Do you, or the joint applicant have any other tenancy elsewhere either individually, together or jointly with
someone else? *
No

If yes please provide details

not entered

What type of property do you live in?

Hotel, bed & breakfast

Other details
not entered

What is your current housing situation?

Bed and Breakfast

Other (please give details)

not entered

If your home is a flat or bedsit please state what floor it is on

1st Floor

How many bedrooms do you have for the people who will be moving with you?
1

i.e. do not count bedrooms that are used by people who are not part of your application, such as parents or friends. Include all
bedrooms, even if they are used for another purpose, such as a study or office

If your property is not based on the ground floor, is it accessible by lift? *

No

If you are a lodger do you share any facilities with other occupants e.g. Kitchen/Bathroom? *
No
If yes please give details
not entered

Are you in specialist or supported accommodation placed by Gedling Borough Council housing need and ready
to move into independent accommodation? *
Yes

If yes please provide details (including Accommodation provider, Contact Name, Contact Number)
not entered

Do you pay rent for your home? *

No

If you rent your room/home how much is the monthly rent?

not entered

Are there any rent arrears at this, or any other previous address? *
No

If yes please provide details of how much you owe and details of the payment plan you have in place
not entered

Please Give your Landlord Details (Name, address and Tel Number)
not entered

Do you or the joint applicant own or pay mortgage on any property? *

No

If yes please provide address

not entered

What is the amount of your monthly payments?

not entered

How much is outstanding on the mortgage?

not entered

If you are currently behind with your repayment please tell us by how much
not entered

Please give us the name and address of your mortgage company

not entered

Section C - Why do you want to move?

Medical & Mobility Needs

Is your current accommodation affecting your health or the health of a member of your household who will be
moving with you? *
No

If yes please provide details of name of person whose health is affected, name of conditions, how would
alternative housing help this condition, illness or disability?
not entered

As a result of this condition does this person require their own bedroom? *
No
Which of these best describes your current situation? I or someone living with me ...

Can only manage one or two steps or stairs

Cannot access parts of my home ie bathroom/kitchen
Cannot be discharged from hospital as my home is no longer suitable
Cannot climb steps or stairs
Cannot live in my home at all owing to a permanent or chronic medical condition
Has difficulty accessing parts of the home ie bathroom/kitchen
Have a child who cannot continue to share a bedroom with a sibling for medical reasons
Have a serious medical condition or disability, which is made worse by my home, which means I cannot live there in
the long term
Other medical reasons (please give details)

If you have ticked any of the above please provide further details
not entered

Do you or anyone moving with you use a wheelchair within your home? *
No

Do you or anyone moving with you use an electric/powered scooter? *

No

Has your home been assessed for adaptations that may assist you? *
No

If yes please give details of who carried out the assessment and what their decision was on adapting your
property
not entered

Do you require specific adaptations to your property to stay there? *

No

If yes please give details

not entered

Does your home have adaptations which you no longer require? *

No

What adaptations do you currently have?

Low level kitchen

Other
Ramped access
Stair lift
Through floor lift
Walk in shower
Widened doors

If "Other" please give details

not entered

Armed Forces - Former Armed Forces

Are you, or someone in your household, a member or former member; within the last 5 years; of either the
Armed Forces, or the Reserve Armed Forces? *
No

Are you a bereaved spouse or civil partner of a member of the Armed Forces leaving Services Family
Accommodation following the death of your spouse or civil partner? *
No
If you have answered Yes to any of these questions, please provide details
not entered

Section C - Why do you want to move?

Violence & Harassment

Are you or a member of your household experiencing violence or abuse at home? *

No

If yes, please give details

not entered

Are you or a member of your household suffering from harassment, threats or violence from a person or
persons not living with you? *
No

If yes, please give details

not entered

If you are fleeing violence what area does the perpetrator live in?
not entered

If you have answered yes to any of the above questions, do you have a preferred way of dealing with the
Homesearch staff? (a safe contact number or address we can send correspondence to)
not entered

Are the police or any other agency currently supporting you to deal with harassment, threats or violence you
are experiencing? *
No

If yes, please give details of who is supporting you along with their contact details
not entered

Request to Leave Your Accommodation

Have you been asked to leave your accommodation? *

No

If yes who has asked you to leave your property?

not entered

What reason were you given for having to leave the property?
not entered

Have you been served with a notice seeking possession/notice to quit/court proceedings/mortgage
repossession papers? *
No

Have you been given a date to leave your property? *

No

If yes what is the date?

not entered

You must provide a copy of any notices you have received upon submitting your application

Existing Tenant With a Desire To Move To a Smaller Property

Are you an existing tenant of a partner in the Homesearch scheme and do you wish to move to a smaller
property? *
not chosen
Are you willing to give up 2 bedrooms or more? *
not chosen

Are you willing to give up 1 bedroom? *

not chosen

Overcrowding

Do you need to move because your property is overcrowded? *

Yes

Describe your overcrowding situation

we are 6 people in the same room.

This information will be checked against the information you have provided in this application, for example, size of property and
number of applicants living with you.

Do you need to move to a bigger property in order to foster children? *

No

Section C - Why do you want to move?

Major Property Defects

Do you have to leave your home due to fire, flood or substantial property damage? *
No

If yes please give details

not entered

If you live in private rented accommodation, have you been made aware during your tenancy that your
landlord has been served with an improvement notice or hazard awareness notice under the provisions of the
Housing Act 2004? *
No

If yes please give details

not entered

Has your home been assessed as statutory overcrowded by an Environmental Health officer? *
No

If yes please give details

not entered

Have you been advised that you may need to leave your home due to major regeneration works? *
No

If yes please give details

not entered

Have you been advised that your property is subject to a Demolition Order, Prohibition Order, or included in a
Clearance Area? *
No

If yes please give details

not entered

If you have answered yes to any of the above questions, please provide supporting documentation

Are there any other reasons why you are applying for housing or is there any other information you wish to tell
us about? *
Yes
If yes please give details
i am in bed and breakfast hotel at the moment.

Section D - Financial Details

Financial Details

If you give us details of your financial circumstances, we may be able to help you to find housing suitable for your needs.

Do you or the joint applicant receive any of the following? (Please provide weekly amounts)

Housing Benefit
not entered

Universal Credit
1150

Income Support
not entered

Job Seekers Allowance

not entered

Employment Support Allowance

not entered

Incapacity Benefit
not entered

Attendance Allowance
not entered

Carers Allowance
not entered

State Pension
not entered

Personal/Work Pension
not entered

Working Tax Credit

not entered

Child Tax Credit

not entered

Child Benefit
150

Disability Living Allowance (Care component)

not selected

Disability Living Allowance (Mobility component)

not selected

Personal Independence Payment

not entered

Severe Disablement Allowance

not entered
Statutory Sick Pay
not entered

Maternity Allowance
not entered

Child Maintenance Payments

not entered

Bereavement Allowance
not entered

Widowed Parents Allowance

not entered

Industrial Injury Benefit

not entered

Pension Credit
not entered

Other
not entered

Do you or the joint applicant have any bank or building society accounts, savings, or investments in the UK or
abroad registered in your name alone or jointly with other people? *
No

If yes, please give details (including name of account, type of account and amount in account)
not entered

Are you or the joint applicant currently experiencing any debt problems? *
No

By providing Homesearch with details of your debts we may be able to offer you advice on how to deal with debt as well as offer
advice on housing options and any impact debt may have on your future housing.

If yes, please give details (including Lenders name, Amount borrowed and outstanding, what type of debt and
date you took on the debt)
not entered

Section E - Convictions
Convictions or Anti-Social Behaviour

Have you, or any member of your household, ever:

Been convicted of any criminal offence (do not include spent convictions or minor motoring offences)?
Had action taken against them due to anti-social behaviour?
Caused wilful damage to any property?
Been violent or threatening towards staff or agents of any council, housing provider, previous landlord or the police?

No

If yes, please give full details below, including dates of conviction and who this applied to. If you declare something here, it does
not necessarily mean you will be excluded from Homesearch. Each case will be assessed individually. However, if you fail to
declare something relating to the above, you could be at risk of losing any tenancy you gain through Homesearch.

Details
not entered
Section G - Your Preferred Areas
Area Of Preference
Carlton (Gedling South)
Mapperley (Gedling South)
Gedling (Gedling South)
Netherfield (Gedling South)
Colwick (Gedling South)
Burton Joyce (Gedling South)
Arnold (Gedling North)
Calverton (Gedling North)
Newstead Village (Gedling North)
Ravenshead (Gedling North)
Lambley (Gedling North)
Woodborough (Gedling North)
Linby (Gedling North)
Bestwood Village (Gedling North)
Papplewick (Gedling North)

Section H - Other Options

Other Options

Do you wish to consider any of these housing options?

Housing association general needs rented accommodation

Private rented
Shared Ownership properties
Sheltered accommodation
Supported Housing
Supporting Information
Supporting Information

You can upload your electronic documents when you submit your application.
You can also bring original documents into your local council where a member of staff will take copies and hand the original
documents back to you. Please contact us if you are unable to get to a council office to provide this information.
We need to see documents to prove each of the following. We need to see proof of these points for both the main and joint
applicants.

1. Your identity and eligibility for social housing

For example, passport, driving license, birth certificate or immigration documents (if you are subject to immigration
control)
2. The current address of each household member (i.e. that they live in the place you have told us)
Proof of address could include a recent utility bill (but not a mobile phone bill), benefit award letter or other official
document sent to you at that address. For children, this could be child benefit.
3. Your current housing situation
For example if you rent your home, your tenancy agreement and details of your deposit protection scheme, if your private
rented tenancy began after October 2015. If you own your own home, a letter or statement from your mortgage lender.
4. Proof of local connection
If you have lived in Gedling borough consistently for the last 12 months or for the last 3 years. We require evidence from
an official body such as Council Tax Liability, benefit letters or other official documents. If you are relying on employment
in the borough, we will need a letter from your employer confirming your place of work, contracted hours and date the
employment commenced. If you are relying on a connection through immediate family ie parent, adult sibling or adult
child (living in the borough for at least the last five years), we will need their name and address and you will need to
evidence that you are providing or receiving care and need to move so that this caring arrangement can continue. As an
example, a Community Care Assessment and/or confirmation of the arrangements by the Adult Social Care Department
would be sufficient, however a letter from a GP would not suffice.
5. Evidence for the reasons you need to move
If you have received a notice to quit you will also need to supply a copy of your gas safety certificate, Government how to
rent booklet, your energy performance certificate and copy of deposit guaranteed scheme. Written confirmation from a
health care professional of your medical condition or disability and how this is affected by your current accommodation.
Written confirmation from your local authority of any hazard in your property or demolition notice. Supporting
information from the police or other agencies you're are working with.
6. Last 2 months bank/building society statements for all accounts
7. Proof of all income, earnings and welfare benefits
8. Proof of Pregnancy
Please provide proof of pregnancy, such as your MAT B1
9. Proof of any criminal conviction

Please contact one of the Homesearch offices if you have any questions about what supporting information to provide.

Required documents
Upload documents

When you submit this form you will also need to provide the following documents:

Proof of address for all household members - a recent utility bill (but not a mobile phone bill), benefit award letter or
other official document sent to you at that address. For children, this could be child benefit.
Proof of identity for all household members (passport, driving license or birth certificate)
Proof of your current housing situation - your tenancy agreement and details of your deposit protection scheme, a letter
or statement from your mortgage lender or a letter from family you are living with.
Proof of local connection - such as Council Tax bill, benefit letters or other official documents, a letter from your
employer confirming contracted hours and date the employment commenced or evidence that you are providing or
receiving care and need to move so that this caring arrangement can continue.
Evidence for the reasons you need to move - If you have received a notice to quit you will also need to supply a copy of
your gas safety certificate, Government how to rent booklet, your energy performance certificate and copy of deposit
guaranteed scheme. Written confirmation from a health care professional of your medical condition or disability and how
this is affected by your current accommodation. Written confirmation from your local authority of any hazard in your
property or demolition notice. Supporting information from the police or other agencies you're are working with.
Last 2 months bank/building society statements for all accounts.
Proof of all income, earnings and welfare benefits

You can either bring copies of these documents to our office, or if you have electronic copies, then you can upload them below -
submitting them electronically is fast and easy.
Application confirmation
Information Sharing & Data Protection

How do we use the information provided on this form?

This form may contain sensitive personal data which will only be processed in accordance with the Data Protection Act 1998.
The information you have given on this application, along with any other supporting information/documentation, will be used to
assess your household's level of need for housing, and, if applicable, advise you about how to manage your debts.
We may use the information you provide on this form, along with any other supporting information/documentation, for the
prevention and detection of fraud. We may also share this information with other organisations that are responsible for auditing
and administering public funds.

Declaration

Please make sure that you read the following statement before you submit this form

I/we declare that the information I/we have given on this application form and any other information I/we may provide in
connection with my/our application is truthful and complete and that I/we have not included information that may misrepresent
my/our true household circumstances. I/we also understand that I/we may be liable for prosecution if any information is
subsequently found to have been false or withheld. If prosecuted by the Homesearch partnership and found guilty, I/we could be
ordered to pay a fine of up to £5000, and if a tenancy has been granted that it may result in the landlord regaining possession of
the property.
I/we understand that I/we must inform the Homesearch team of any change in my/our household circumstances.
I/we understand that the information I/we have given may be shared with partner organisations within the Homesearch scheme
and other third parties such as credit reference agencies, other landlords, the police, social services etc. I/we give my permission
for the Homesearch team to share this information in order to verify my/our household circumstances and confirm that the
information I/we have given is correct.
I/we understand that the Homesearch team may approach other organisations or agencies in order to obtain further information
relevant to my/our application. I/we give my/our permission for said organisations to disclose my/our personal details in order to
assist the Homesearch team with my/our application.

This will be replaced with the household name..

I/we confirm that we have read and agree to the above declaration statement *
Yes