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 ID / Picture

  • Is this a joint tenancy?

  • Joint tenants ID / picture

  • Joint tenants title

  • 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

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

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.