Backdate Application

Claimant Details

Can be found on any letter we have sent you and begins with a "2"









Period Benefit(s) Required

Housing Benefit

DD/MM/YYYY

DD/MM/YYYY
Council Tax Support

DD/MM/YYYY

DD/MM/YYYY




Declaration

I understand the following:

  • If I give information that is incorrect or incomplete, you may take action against me.
  • You will use the information I have provided to process my claim for Housing Benefit or Council Tax Support, or both.
  • You may check some fo the information with other sources within the Council, Rent Offices and other Councils.
  • You may use any information I have provided in connection with this, and any other claim for Social Security benefits that I have or may make. You may give some information to other Government organisations, if the law allows this.

I know I must let the Council know about any changes in my circumstances which may affect my claim.

I declare the information I have given on this form is correct and complete.

 


Privacy Statement

Peterborough City Council abides by the principles of data protection and information is collected, processed and stored in compliance with data protection legislation.

For more information then please see our privacy notice on who we may work with and how we may use your data. It can be viewed online at https://www.peterborough.gov.uk/council/council-data/corporate-privacy-notice/  or a copy is available at all council offices.