Lewisham Council - Council Tax - Band reduction application

Council tax band reduction

Application form for people with disabilities

Details about the person who is disabled
Name:

Address:


Postcode:

Does the person named above live permanently at this address?
	Yes	No


How many people in total live here?

Please answer Yes or No to all the following:
Was a second bathroom or kitchen added for meeting the needs of the disabled person?
	Yes	No

Was extra space allowed inside the property for wheelchair use?
	Yes	No

Is a wheelchair used indoors at all times?
	Yes	No

Is a room mostly used to meet the needs of the disabled person?
	Yes	No
If Yes, which room?

How is the room used?


Additonal Information
You don't have to give us this, but it could help us make an appointment to visit your property if we need to.
Your daytime phone number

Declaration
This section should be completed by the person submitting this form.
I am the liable person


You can claim from the date the property was adapted or first used for the well being of the disabled person
I am claiming a reduction from:
dd/mm/yy

If you are filling out this form on behalf of someone else please state your relationship to them.


I declare to the best of my knowledge, the information I have given is correct. I understand I am legally required to give you information. I also understand that if my circumstances change, I must tell you immediately. I further understand I can be prosecuted for knowingly claiming a reduction to which I am not entitled. check box to agree

London Borough of Lewisham