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Council Tax - Single Person Discount Claim Form

By completing the form below, you have declared that the information you have provided is correct. Providing false information to claim a Council Tax discount is a criminal offence.

Your Council Tax Account Reference Number

You will find your nine digit account reference number on your Council Tax bill. (This number will start with a 9)
If you have recently moved into your new home and not yet received a Council Tax reference number, please leave this blank.

All fields marked with (*) are mandatory.

Your First Name ^*

Your Last/Family Name ^*

The address of the property where you wish to claim a single person discount

Property Name/Number ^*
Street/Road ^*
Locality (optional)
Town ^*
County
Post Code ^*

Is this your only residence? ^*

Yes

If no, please supply the address of you other residence below:

Address

If we have a query in processing your application, we may need to speak to you. Please provide a daytime telephone number where you can be contacted.

Telephone number

Email address

The date from which you wish to claim a Single Person Discount (DD/MM/YY) ^*

This is the date when you became the only adult living in the property.

Today's date

If you are claiming a discount because someone has recently left your household, please provide the following information:

Name of person moving out

Their new address

If you are now the sole adult occupier due to the death of a previous occupier, could you provide the following information:

Name of deceased person

Date of death

Declaration

The information given on this form is correct. If my circumstances change whereby I would not be entitled to the Single Person Discount I will inform the Council Tax office immediately. I understand that failing to do so, or providing false information may lead to prosecution

Tick this box if you agree with this declaration ^*

Please note: After you have submitted this form, confirmation of your submission will result in a reference number being displayed on screen

Date submitted

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