Public Services
Revenues
Laurence House
Catford
LondonSE6 4RU
direct line 020 8690 9666
fax 020 8314 3155
Our ref
Your ref
COUNCIL TAX DISCOUNT APPLICATION FOR CARERS AND CAREWORKERS
Please complete:Part 1 (if you are a careworker) Answer questions 1-9
Part 2 (if you are caring for a friend, relative or another person you live with) Answer
questions 1-7
Everyone must complete parts 3 and 4.
Part 1 – Careworkers
1.Name and address of liable person:
2.Name of person receiving care if different to (1) above:
3.Name of Careworker if different to (1) above:
4. Number of adults in the property
5.Is the careworker a resident carer
YesNo
6.If Yes, Please state careworkers previous address, If no, please state careworkers current address
7. When did the careworker move in to the property. Exact Date: / /
8.Name & address of employer if different to person receiving care
9.Gross weekly pay £ Number of hours worked each week hours
Please enclose a copy of your contract of employment
Part 2 - Carers
1.Name of person receiving care if different to (1) overleaf
2.Name of careworker if different to (1) overleaf
3.Number of adults in the property
4.Does the carer live with the person receiving care Yes No
5.Number of hours care provided each week hours
6.Which of the following benefits does the person receiving care get
Higher rate attendance allowance
the highest rate of the care component of disability living allowance
the highest rate of disablement pension
an increase in constant attendance allowance
We must see proof of these benefits to support your application. Please do not post benefit books, we will be happy to look at them in our AccessPoint in Laurence House.
7.Is the person receiving care: a child of the carer; aged under 18; or a husband, wife or partner
of the carer Yes No
Part 3 - Carer
Careworker/Carer
I am the liable person and am claiming a discount/exemption from / /
Signed Date / /
If you have signed this form on behalf of the liable person, please state your relationship with them
Part 4 - Carer
I declare, to the best of my knowledge, the information I have given is correct.
I understand I am legally required to give you correct information. I also understand that if my circumstances change I must tell you immediately.
I am aware I can be prosecuted for knowingly claiming a discount to which I am not entitled.
Signed Date / /
Full name
(please print your name clearly)
I understand that the information I have supplied will be retained and used by the Council in connection with the collection of Council Tax. I consent to the information being disclosed to other parts of the Council and to third parties (e.g. the Benefits Agency), or in such other circumstances where the law might otherwise allow. I also understand that I have a right of access to the information the Council holds in respect of me and that I may obtain a copy of the information upon written request and payment of the required fee.
Please return your form to: Council Tax, PO box 1221, LondonSE6 4RTwithin the next 14 days.
If you are entitled to a discount or exemption we will send you a new bill showing the reduction.
If you are not entitled, we will write to you and tell you why.
If you need further help or advice please see the enclosed leaflet for details on how to contact us.
Carers Discount form.doc