HRA Tenancy Audit

• Rent account number

• Location
  Address

• Property address

• Rent account balance

• Audit completed on visit number...

  1

  2

  3

• Staff member completing audit

  Select Chris Rourke Adetoun Ajayi Myra Dicken David Crofts Thomas Austin Michael Opreshko Sarah Thompson Lee Georgiou Tee Aminu Dee Salter Vicki Percival Geoff Baker Matt Macmillan

  • Chris Rourke
  • Adetoun Ajayi
  • Myra Dicken
  • David Crofts
  • Thomas Austin
  • Michael Opreshko
  • Sarah Thompson
  • Lee Georgiou
  • Tee Aminu
  • Dee Salter
  • Vicki Percival
  • Geoff Baker
  • Matt Macmillan

Tenancy details

• Tenancy start date

  Date

• Tenancy type

  Introductory

  Homeless Licence

  Secure

  Flexible

Tenants details

• Tenants title:

  Select Miss Mrs Ms Mr Dr Rev Sir Lady

  • Miss
  • Mrs
  • Ms
  • Mr
  • Dr
  • Rev
  • Sir
  • Lady

• Please enter tenants full name

• Tenants DoB

  Date

• Tenants national insurance number

• Tenants full address
  Address

• Contact details (telephone / mobile phone / email etc)

Contact details

• Tenants photo ID / Picture

  Media

• Is this a joint tenancy?

  Yes

  No

• Joint tenants ID / picture

  Media

• Joint tenants title

  Select Miss Mrs Ms Mr Dr Rev Sir Lady

  • Miss
  • Mrs
  • Ms
  • Mr
  • Dr
  • Rev
  • Sir
  • Lady

• Please enter joint tenants full name

• Joint tenants date of birth

  Date

• Joint tenants national insurance number

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

Contact details

Household

• Please add each childs details

Child details

• Name

• Gender

  Male

  Female

• Date of birth

  Date

• Relationship to tenant

  Select Son / daughter Grand child Niece / nephew Other Step son Step daughter Parent Aunt / uncle Grand parent Partner

  • Son / daughter
  • Grand child
  • Niece / nephew
  • Other
  • Step son
  • Step daughter
  • Parent
  • Aunt / uncle
  • Grand parent
  • Partner

• Please enter relationship to tenant

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

Adult details

• Name

• Gender

  Male

  Female

• Date of birth

  Date

• Relationship to tenant

  Select Son / daughter Grand child Niece / nephew Other Step son Step daughter Parent Aunt / uncle Grand parent Partner

  • Son / daughter
  • Grand child
  • Niece / nephew
  • Other
  • Step son
  • Step daughter
  • Parent
  • Aunt / uncle
  • Grand parent
  • Partner

• Please enter relationship

• Identity / proof of residence

  Media

Pets

• Are there any pets in the household?

  Yes

  No

• Please enter each pets details

Pet

• Has pet been registered?

  Yes

  No

• Species:

• Has the pet been micro-chipped?

  Yes

  No

• Is the pet neutered?

  Yes

  No

Property details

• Number of bedrooms

  1 Bed

  2 Bed

  3 Bed

  4 Bed

  5 Bed

• Property type

  Select Flat Terraced house Bungalow End of terrace Semi-detached Maisonette Sheltered housing

  • Flat
  • Terraced house
  • Bungalow
  • End of terrace
  • Semi-detached
  • Maisonette
  • Sheltered housing

• Have you been able to inspect all rooms?

  Yes

  No

• Please provide details of refusal of access:

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

  Yes

  No

• Was approval granted?

  Yes

  No

• Please provide details

• Are there any signs of damage to the property?

  Yes

  No

• Please give details of damage:

• Please add image if appropriate

  Media

• Are there repairs needed to the property?

  Yes

  No

• Have the repairs been reported?

  Yes

  No

• Please provide details of repair needed

Hazards

• Are there any combustable materials stored at the property?

  Yes

  No

• Please provide details:

• Please add image if appropriate

  Media

• Is there a smoke alarm at the property?

  Yes

  No

• Is it hard wired?

  Yes

  No

Utilities

• Does the property have gas, electricity or both?

  Only gas

  Only electricity

  Both

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

  Media

• 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)

  Media

• 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)

  Media

• 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)

  Media

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

Financial issues

• Does the tenant have any rent arrears?

  Yes

  No

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

  Yes

  No

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

• Is the tenant claiming Housing Benefit?

  Yes

  No

• Is the tenant Under / Over occupying the property?

  Under occupied

  Over occupied

  Neither

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

  None

  Over night carer

  Serving soldier

  Child with disability

• Would the tenant like to find a larger property?

  Yes

  No

• Are there any outstanding issues with their HB claim?

  Select Overpayment Suspension Information required Un-notified change of circs None

  • Overpayment
  • Suspension
  • Information required
  • Un-notified change of circs
  • None

• Please raise referral to Housing Officer / Welfare Reform Team

Support requirements

• Does anyone in the household have a registered disability?

  Yes

  No

• Are they in receipt of disability benefits?

  Yes

  No

• Referrals to be made (please select all)

  Select AP1 CP1 Welfare Reform Team CAB MacMillian WBU Transfer / Mutual exchange Residents association Other Repair Stepchange Caring hands

  • AP1
  • CP1
  • Welfare Reform Team
  • CAB
  • MacMillian WBU
  • Transfer / Mutual exchange
  • Residents association
  • Other
  • Repair
  • Stepchange
  • Caring hands

• Please give details of support required

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

  Sign