marylin monroe
Housing Benefit and Council
Tax Benefit Claim Form
Our commitment to you: “To provide an inclusive and secure Benefits service that pays the right people, the right amount of benefit at the right time.”
Title (Mr, Mrs, Miss, Ms)
Surname/family name
First names
Address
Postcode
Telephone number
Housing benefit & council tax benefit reference (if you have claimed at Westminster before)
7-figure number
• Fill in this form to claim help with your rent or council tax.
• Tick the box that applies to you.
✓
If you want us to contact you by email, please write your email address below. You should not use email to tell us about changes in your circumstances. You must tell us by letter.
Do you pay rent to the council?
Yes
No
Do you pay rent to a housing association?
Yes
No
Do you live in a hotel?
Yes
No
Do you pay rent to a private landlord?
Yes
No
Do you live in a hostel?
Yes
No
Are you an owner-occupier?
Yes
No
Yes
No
Has our Housing Options Service or Social Services Department placed you in your accommodation?
• Please complete this form in black ink.
• Please read the notes leaflet, then fill in the form and return it to us straight away.
• You will need to provide various original documents or proofs to support your claim for benefit.
• Even if you do not have all the proofs we want, you must return this form to us immediately or you will lose benefit.
• You must provide the missing proofs within one month or we may decide you are not entitled.
• If you need help with this form or you need more information, please contact the Westminster City Council Benefits
Service. By telephone: Freephone 0800 072 0042, 8am to 6pm Monday to Friday. By email: cityofwestminsterbenefits
@capita.co.uk. In person: 180 Vauxhall Bridge Road, SW1V 1ER – 8.30am to 6pm, Monday to Friday or 101
Orchardson Street, NW8 8EA – 8.30am to 5pm, Monday to Friday. For more information on council tax,
Tax Benefit Claim Form
Our commitment to you: “To provide an inclusive and secure Benefits service that pays the right people, the right amount of benefit at the right time.”
Title (Mr, Mrs, Miss, Ms)
Surname/family name
First names
Address
Postcode
Telephone number
Housing benefit & council tax benefit reference (if you have claimed at Westminster before)
7-figure number
• Fill in this form to claim help with your rent or council tax.
• Tick the box that applies to you.
✓
If you want us to contact you by email, please write your email address below. You should not use email to tell us about changes in your circumstances. You must tell us by letter.
Do you pay rent to the council?
Yes
No
Do you pay rent to a housing association?
Yes
No
Do you live in a hotel?
Yes
No
Do you pay rent to a private landlord?
Yes
No
Do you live in a hostel?
Yes
No
Are you an owner-occupier?
Yes
No
Yes
No
Has our Housing Options Service or Social Services Department placed you in your accommodation?
• Please complete this form in black ink.
• Please read the notes leaflet, then fill in the form and return it to us straight away.
• You will need to provide various original documents or proofs to support your claim for benefit.
• Even if you do not have all the proofs we want, you must return this form to us immediately or you will lose benefit.
• You must provide the missing proofs within one month or we may decide you are not entitled.
• If you need help with this form or you need more information, please contact the Westminster City Council Benefits
Service. By telephone: Freephone 0800 072 0042, 8am to 6pm Monday to Friday. By email: cityofwestminsterbenefits
@capita.co.uk. In person: 180 Vauxhall Bridge Road, SW1V 1ER – 8.30am to 6pm, Monday to Friday or 101
Orchardson Street, NW8 8EA – 8.30am to 5pm, Monday to Friday. For more information on council tax,