Information

  • Rent account number

  • Location
  • Property address

  • Rent account balance

  • Audit completed on visit number...

  • Staff member completing audit

Tenancy details / Occupants

Tenancy details

  • Tenancy start date

  • Tenancy type

Tenants details

  • Tenants title:

  • Please enter tenants full name

  • Tenants DoB

  • Tenants national insurance number

  • Tenants full address
  • Contact details (telephone / mobile phone / email etc)

  • Contact details
  • Tenants photo

  • Tenants ID

  • How do you pay your rent?

  • Do you work

  • What is your income?

  • Proof of income

  • Do you work full time or part time?

  • What is your income?

  • If you are on benefits, list what benefits and total amount received

  • Do you have any outstanding debts?

  • List debts and amounts

  • Is this a joint tenancy?

  • Tenants photo

  • Tenants ID

  • Joint tenants title

  • Add media

  • Please enter joint tenants full name

  • Joint tenants date of birth

  • Joint tenants national insurance number

  • Joint tenants contact details (telephone / mobile phone / email etc)

  • Contact details
  • Do you work

  • What is your income?

  • Proof of income

  • Do you work full time or part time?

  • What is your income?

  • If you are on benefits, list what benefits and total amount received

  • Do you have any outstanding debts?

  • List debts and amounts

Condition of property

  • Lounge

  • Why has it failed?

  • Kitchen

  • Why has it failed?

  • Landing and hallway

  • Why has it failed?

  • Bathroom

  • Why has it failed?

  • Garden

  • Why has it failed?

  • Add media

  • Sheds and out buildings

  • Why has it failed?

  • Add media

  • How many bedrooms are in the property?

  • Bedroom 1

  • Why has it failed?

  • Add media

  • Bedroom 1

  • Why has it failed?

  • Bedroom 2

  • Why has it failed?

  • Bedroom 1

  • Why has it failed?

  • Bedroom 2

  • Why has it failed?

  • Bedroom 3

  • Why has it failed?

  • Bedroom 1

  • Why has it failed?

  • Bedroom 2

  • Why has it failed?

  • Bedroom 3

  • Why has it failed?

  • Bedroom 4

  • Why has it failed?

Household

Household

  • Please add each childs details

  • Child details
  • Name

  • Gender

  • Date of birth

  • Relationship to tenant

  • Please enter relationship to tenant

  • Please add each adults details (other than tenant / joint tenant)

  • Adult details
  • Name

  • Gender

  • Date of birth

  • Relationship to tenant

  • Please enter relationship

  • Identity / proof of residence

Pets

  • Are there any pets in the household?

  • Please enter each pets details

  • Pet
  • Has pet been registered?

  • Species:

  • Has the pet been micro-chipped?

  • Is the pet neutered?

Property

Property details

  • Number of bedrooms

  • Property type

  • Have you been able to inspect all rooms?

  • Please provide details of refusal of access:

  • Have there been any structural changes to the property during the tenancy?

  • Was approval granted?

  • Please provide details

  • Are there any signs of damage to the property?

  • Please give details of damage:

  • Please add image if appropriate

  • Are there repairs needed to the property?

  • Have the repairs been reported?

  • Please provide details of repair needed

Hazards

  • Are there any combustable materials stored at the property?

  • Please provide details:

  • Please add image if appropriate

  • Is there a smoke alarm at the property?

  • Is it hard wired?

Utilities

Utilities

  • Does the property have gas, electricity or both?

  • Please photograph the meter including piping to the unit (take multiple photos if necessary)

  • Please enter the meter reading if not legible in the image

  • Please photograph the meter including wiring to the unit (take multiple photos if necessary)

  • Please enter the meter reading if not legible in the image

  • Please photograph the meter including piping to the unit (take multiple photos if necessary)

  • Please enter the meter reading if not legible in the image

  • Please photograph the meter including wiring to the unit (take multiple photos if necessary)

  • Please enter the meter reading if not legible in the image

Tenant support needs

Financial issues

  • Does the tenant have any rent arrears?

  • Has an affordable arrangement been put in place and being adhered to?

  • Please raise referral to Housing Officer / Welfare Reform Team for affordable repayment plan

  • Is the tenant claiming Housing Benefit?

  • Is the tenant Under / Over occupying the property?

  • Could the tenant satisfy one of the exemptions from size criteria? please select as appropriate

  • Would the tenant like to find a larger property?

  • Are there any outstanding issues with their HB claim?

  • Please raise referral to Housing Officer / Welfare Reform Team

Support requirements

  • Does anyone in the household have a registered disability?

  • Are they in receipt of disability benefits?

  • Referrals to be made (please select all)

  • Please give details of support required

Declaration

Comments / Statements

  • Officer comments

  • Tenants comments

Declaration

  • I declare that the information I have given for the purposes of this form is true and accurate. I understand that giving false information may amount to fraud and I would put my tenancy at risk with the result being that I may loose my home. I may also be subject to criminal prosecution.

  • Tenant signature

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