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HOUSING ALLOWANCE APPLICATION FORM FOR TENANTS INSTRUCTIONS 1 Employees who are/became tenants on or after 1 January 2005 should complete this application form. 2 Complete and tick the boxes that
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included the correct name and residential address of the employer and the appropriate section of the DWP (i.e.'s) Housing Allowance application form for the number of months you are or became a tenant. In particular: If you have an employment, work-related benefit claim form, please attach the Employment and Support Allowance form (for example, ESA for the first two months). If you have a disability benefit claim form, please attach the Personal Independence Payment form (Misc Benefits). 5 Please ensure both your Employment and Support Allowance ( ESA) and the Personal Independence Payment are completed and tick in the appropriate boxes on the Housing Allowance application form. NOTE: If you have no employment, work-related benefit claim form but you do have a Disability Benefit claim form, you do not need to complete this section. 6 If you cannot produce your ESA form, the DWP will require that you show evidence of ESA entitlement. The appropriate form can be found on the DWP webpage at www.mcc.gov.uk. 7 If you do not have a valid ESA form, you may not be eligible for the Rent Supplement and/or Housing Benefit. If this is the case and you are not eligible for either of these benefits, you will also be eligible for Jobseeker's Allowance as a 'long-term sicko'. If you are awarded Jobseeker's Allowance as a 'long-term sicko' there is no rent supplement available, and the total amount you can receive would be reduced to zero. You must be claiming Rent Supplement and/or Housing Benefit, where necessary. 8 Please ensure that you ensure that either your ESA form or the appropriate ESA form for your claimant for the period of the claim has been completed and ticked in Section B of the Housing Allowance application form. 9 Please also ensure you provide your Employer's name, a line for your name and address and your Employer's number on the appropriate section of the Housing Allowance application form. 9B If you are applying for an increase on the Housing Allowance as you have been a tenant for 5 years or more, please attach a copy of your ESA Claim form to your application forms. 10 Please use this form for the following: If you are now or have previously been a 'Long-term sicko'. If you have an 'in arrears' Housing Benefit. If you are an employee or student who has had a benefit claim rejected. If you
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