Discretionary Housing Payments

A Discretionary Housing Payment (DHP) is intended to help towards eligible housing costs and ismade entirely at the discretion of the Council. Whilst it is not a payment of benefit, a DHP can only be made if Housing Benefit or Housing Costs (within Universal Credit award) is already in payment. Some things that maybe included in your housing costs, e.g. heating, water, electricity etc. do not qualify for a DHP.

Section A

Your Name : Partner’s Name :
Address :
Telephone Number:
Email Address :
Are you in receipt of Housing Benefit? - Yes No
Are you in receipt of Universal Credit? – Yes No
If ‘yes’ you will need to provide your award letter
Date of Application:
If you would like us to consider backdating an award please tell us why you did not apply earlier in section B

Section B

1.Why do you wish to apply for Discretionary Housing Payment?
2.Why did you move to this address and what if anything, makes this address
suitable for you?
3.Please tell me about any health problems that you or any member of your family might have.
* If you, or a member of your family, are receiving treatment it would help if we had a
letter from your doctor to confirm this.
4.Have you tried to agree a lower rent with your landlord? Yes No
If you have tried to agree a lower rent tell me what happened.*
* If your landlord has agreed a lower rent I will need to see a new lease or a letter
letter from your landlord.
5.Do you have any relatives or friends who could help you?

SECTION C

Income and Expenditure

Outgoings / Amount you pay / How often (e.g. weekly or monthly) / How much do you owe?
Rent
Council Tax
Mortgage
Food
Clothing
School Dinners
Gas
Electricity
Other fuel costs
Telephone
TV Licence
TV/other rental
Buildings/contents insurance
Life insurance
Travel
Car Insurance
Road Tax
Petrol
Alcohol/Tobacco
Catalogue
Bank Loan
Other Loan
Entertainment
Holidays
Savings
Other (please detail)
Other (please detail)
Other (please detail)
Total

SECTION D

This section should only be completed if you are in receipt of Universal Credit

  1. Please confirm who is resident in the property:

Name:

Date of Birth:

National Insurance Number:

Relationship i.e. son, daughter:

Name:

Date of Birth:

National Insurance Number:

Relationship i.e. son, daughter:

Name:

Date of birth:

National Insurance Number:

Relationship i.e. son, daughter:

Name:

Date of Birth:

National Insurance Number:

Relationship i.e. son, daughter:

Name:

Date of Birth:

National Insurance Number:

Relationship i.e. son, daughter:

  1. How many bedrooms you have in your property:
  1. Please submit your bank account details in order that your payment can be made if an award is granted:

Bank Account Name:

Sort Code:

Account Number:

Please submit your Universal Credit Award Letter and lease/letter from your landlord confirming your rent charge (including details of any service charges)

Section E

Declaration

Please read this carefully before you sign the form
I declare that the information I have given on this form is correct and complete to the best of my knowledge.
If the information I have given changes at anytime I will notify the City of Edinburgh Council immediately.
I understand that if the information I have given is incorrect I may be prosecuted.
I authorise the City of Edinburgh Council to make enquiries to confirm the information I have given unless I have indicated otherwise.
I authorise the City of Edinburgh Council to cross check the information I have given with other sections of the Council within the terms of the Data Protection Act 1998.

Signatures

Claimant’s Signature : Date : _____ / _____ / _____
Partner’s Signature : Date : _____ / _____ / _____
If completed by someone other than the claimant please state your relationship:

Please return your form to:

The City of Edinburgh Council,

PO Box 12331,

Edinburgh,

EH7 9DN.

Or email form to:

Notes

The Council only has a limited budget to make these payments so they are made on merit and normally on a short-term basis. If the information you give us shows that you could afford the shortfall in your housing costs it is unlikely that we would award you a Discretionary Housing Payment. You may still benefit from advice and assistance to help you budget your income, accordingly, if you would like further advice please contact our Advice Shop at 249 High Street, Edinburgh, EH1 1YJ or telephone 0131 200 2360.

If you want to apply for a Discretionary Housing Payment you should complete and return this form.

Please provide the information requested and supply any available supporting evidence. If you donot supply enough information we may have to contact you and this will delay our decision.

BACKDATING

We may be able to backdate your application at our discretion if you have good reason for the delay in making your application.

ADDITIONAL ROOMS

You may be allowed the use of an additional room, for example:

· you may be unable to share a bedroom with your partner due to illness or

disability; or

· you may require use of a room for a non-resident overnight carer, or

· you have a disabled child who is unable to share with a sibling, or

· where you have a son or daughter currently on active duty with the armed forces, or

· if you are a foster / kinship carer.

Please provide all information and any relevant supporting evidence.

DISABLED ADAPTATIONS TO YOUR PROPERTY

We may be able to award a longer period of DHP if your property has been significantly adapted tomeet your / your partner’s disabled needs. Please tell us about any adaptations such as:

· Bathroom and Toilet adaptations (wet floor shower, additional toilet etc.)

· Access to the home (wheelchair access, ramps, step alterations, handrails etc.)

· Kitchen and Living Space adaptations

· Lifts (stair lifts, through-floor lifts, step lifts etc.)

· Hoists

· Other small adaptations and specialist equipment

RECONSIDERATIONS

If you disagree with our decision you may ask in writing for your case to be looked at again.