Council Tax Reduction - Application for Disability Relief
Progress Tracker
Applicant
Please read the
Information about Council Tax Disability Relief
before completing this application.
Applicant Details
This form MUST be filled in by the Council Tax payer.
Your full name
Council Tax Reference (if known)
Postcode
Daytime telephone number (
we need this to make an appointment
)
Email address
Full name of disabled person (if different from above)
What is their disability?
Alterations
My home has been altered in the following way: (please tick all boxes which apply)
A room (not kitchen, bathroom or toilet) that is used mainly by the disabled person.
Yes
No
An additional bathroom or kitchen for the use of the disabled person.
Yes
No
Extra floor space inside the home to allow the use of a wheelchair.
Yes
No
I know that I must let you know about any changes in circumstances which might affect any reduction in Council Tax I may qualify for.
Yes
No
I declare the information I have given above is correct.
Yes
No