Application Form

This is a primary-stage application form. Once you place a bid on an available property and are at the point where we have shortlisted you for a home, we will ask for further information. Please ensure all the information you enter is correct at the time of making the application. Any information found to be false or inaccurate will invalidate your application.

Main applicant
Your current address including post code
The purpose of this question is to help us to discover whether people are treated fairly when they apply for housing. The information gathered from this question will be used to help us to fight racial discrimination and improve the quality of our services. If you do not wish to answer this question, you can choose to refuse.
Do not leave any spaces e.g. QQ123456C
The Equality Act defines a disabled person as someone who has a physical or mental impairment that has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities.
Please provide details below.
Joint applicant
The purpose of this question is to help us to discover whether people are treated fairly when they apply for housing. The information gathered from this question will be used to help us to fight racial discrimination and improve the quality of our services. If you do not wish to answer this question, you can choose to refuse.
Do not leave any spaces e.g. QQ123456C
The Equality Act defines a disabled person as someone who has a physical or mental impairment that has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities.
Other occupants
Occupant 1
Occupant 2
Occupant 3
Occupant 4
Occupant 5
Occupant 6
Occupant 7
Is there anyone or an organisation you wish to give permission to act on your behalf?
Please provide the name and contact details of any support workers or any family member assisting you.
Please provide details of any pregnant household member - Name, when is the baby due?
£
Please enter an approximate figure, including any benefit payments you receive.
We ask this question because we can provide translation services if necessary.
If you cannot understand English. What language do you speak?
Supporting documents
Such as, passport, immigration documentation, driving licence, birth certificate
Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.
Such as, council tax or utility bill, bank or credit card statement
Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.
By confirming the details on this application: You consent to information in this application being used to detect and/or prevent fraud. You agree to the information given in this form being held and processed in computer and other records. Agree to LYHA verifying the information on this form at anytime, we may check it with, or pass it on to, organisations such as; Police/Local Authorities/Current and former landlords/GPs and other medical practitioners/Hospitals/ Banks and building societies/Credit reference agencies and other relevant organisations for the purpose of assessing your application for housing. Agree to allow LYHA to carry out an affordability check of your household via our online tool Insight. If any of the information you give on this form or from references is false or wrong, we may reject your applications. If we find out after you have been given a home, we make take steps to re possess the property.