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Information summary
1. Introduction Below is a summary of the information you have provided. Please check it is
2. Guidance notes correct, then check the declaration box and submit your application
3. Initial questions
If anything appears incorrect, please use the pages menu to go back and
4. Your details
make amendments
5. Items
6. Your rent
7. Questions Applicant name
8. Contact details Mr Michael Broster
9. Your income
10. Your expenses
11. Your household Gender
12. Special circumstances Male
13. Disabilities
14. Supporting documents
15. Summary Date of birth
11/02/82
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Nationality
-United Kingdom - England

National Insurance number

JR055680A

Address
326 Bolton Road, Radcliffe, M26 3GP

Tenure
Private rented

Your rent

Rent
600

Paid every
Monthly

Required payment start date

09/09/23

Landlord

Landlord company
Green Co Lettings

Landlord address
19 Leicester road, Salford, M7 4AS

DHP event: short-term rental costs for any other reason

Has this application been completed with help/support from any

agency/support worker?
No

Have you claimed a discretionary housing payment in the last 12

months?
No

Please tell us what you are applying for extra help with
Rent

How long are you likely to need help for?

untill my pip is re-instated after my tribunal. I don't have a date for that yet
though.

Were you able to afford the rent when you moved in?
Yes

If yes please give details of why you can no longer afford the rent?
My PIP has been stopped reducing my income by over £500 a month

Do you have any rent arrears?

Yes

If yes what are your rent arrears and has your landlord taken any action
to recover these?
Not yet but they are close to

Please give details of any negotiations you have had with your landlord
to try to reduce your rent.
They are not interested in negotiations

When does your current tenancy end?

july 2024

How much notice would you need to give your landlord?

2 months

Is there any reason why you could not move?

Yes

If yes what is the reason for not being able to move?

I can't afford it.

Have you registered with Six Town Housing or any other social landlords?
No

Have you tried to find cheaper accommodation?

Yes

If yes what steps have you taken to find cheaper accommodation?

I've looked at various estate agents but there's nothing even remotely
cheaper anywhere near here.

Does anyone living with you at your home address suffer from an illness
or disability?
Yes

If yes please give details of illness or disability. Please provide any

information about over night care you may need.
I suffer from Agoraphobia, Anxiety, Depression and ADHD

Use this space to tell us about any special circumstances.

If we are evicted we have no where else to go

Do you give permission for us to discuss your application with your

landlord?
Yes

Are you affected by the benefit cap?

No

Discretionary housing payment items selected

Discretionary Housing Payment award

Email address
Brostermike@hotmail.com

Daytime telehpone
07729206942

Mobile
07729206942

Account holder
Michael Broster

Sort code
090128

Account number
88312733

Your income from benefits

Type of benefit
State Benefit

Amount
257

Frequency
Fortnightly

Next payment date

22/09/23

Type of benefit
Child Benefit

Amount
25

Frequency
Weekly

Next payment date

25/09/23

Your household outgoings

Type of expense
Food and Housekeeping

Amount
150

Frequency
Monthly

Next payment date

18/09/23

Type of expense
Electric

Amount
68

Frequency
Monthly

Next payment date

14/10/23

Type of expense
Rent paid

Amount
600

Frequency
Monthly

Next payment date

09/10/23

Type of expense
Water rates

Amount
27

Frequency
Monthly

Next payment date

16/10/23

Type of expense
Phone

Amount
50

Frequency
Monthly

Next payment date

18/10/23

Type of expense
Travel expenses (car or public)

Amount
40

Frequency
Monthly

Next payment date

18/09/23

Your income from Repayments

Type of Repayment
Credit cards

Amount
54

Frequency
Monthly

Next payment date

07/10/23

Final payment date

31/12/24

Children

Child name
Master Alexander Broster

Gender
Male

Date of birth
23/12/16

Relationship
Son or Daughter (including adopted)

Special circumstances selected

Mr Michael Broster Mental health impairments

Mr Michael Broster Being a lone parent

Master Alexander Broster Children living with a disabled adult

Mr Michael Broster Responsibility as a main care giver

Disabilities selected

Mr Michael Broster Mental

Application Method
Internet (in person)

Extra information
Green Co have sent me a text message 2 days from the date of this form
telling me I have rent arrears from March totalling £300. I have no way of
getting £300 together and they are not answering phones or responding to
emails. They said if I don't respond within 24 hours they would "take
action" but they sent the text on a Friday and where closed over the
weekend. I'm now terrified that we're going to be homeless in a couple of
weeks.

Declaration
I declare that the information I have given in my application is true and
complete and I will inform you straight away if my circumstances change.

I understand you may check if I am eligible for any other support from Bury
Council or other agencies. I understand that you may also check the
information I provide with other sources within the council, other councils
and government departments. I understand you may also contact third
parties such as banks and organisations that lend money and companies
that assist in detecting and preventing fraud as allowed by law.

I understand that if I give information that is incomplete or incorrect you

may take action against me. This may include court action.

Tick to confirm you have read and understood the declaration

Use this to print out the summary shown of the information you have
supplied.

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