• 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 date of birth

  • Tenants full address
  • Contact details please enter telephone / mobile phone & email

  • Contact details
  • Landline

  • Mobile phone

  • Email

  • Tenants photo ID / Picture

  • Employment / Student status

  • Does the tenant receive any of the following (please select all)

  • Please enter other income

  • Is this a joint tenancy?

  • Joint tenants title

  • Please enter joint tenants full name

  • Joint tenants date of birth

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

  • Contact details
  • Joint tenants ID / picture



  • 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


  • Are there any pets in the household?

  • Please enter each pets details

  • Pet
  • Species:

  • Has the pet been micro-chipped?

  • Has pet been registered?

  • Does the pet belong to a household member?

  • Please give name and address of owner and expected duration of stay


Property details

  • Number of bedrooms

  • Property type

  • Please provide location of W/C

  • Are there any downstairs bedrooms?

  • Which floor is the flat situated on?

  • Is the property wheelchair accessable?

  • Have any adaptations been made to the property in respect of a disability?

  • Please select as appropriate

  • Please provide details:

  • Have there been any structural improvements to the property?

  • Was approval granted?

  • Please provide details

  • Have you been able to inspect all rooms?

  • Please provide details of refusal of access:

  • 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

  • Please add image if appropriate


  • 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?

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

Welfare Reform

Welfare Reform

  • Have you heard about Welfare Reform?

  • Are you aware that Universal Credit will be paid into your bank account and be paid monthly in arrears?

  • Do you currently have a bank account?

  • Would you be interested in opening a budgeting account if the Council could make one available to you through a local bank or building society?

  • Have you heard of Credit Unions?

  • Do you use door step lenders or have you ever taken a pay-day loan?

  • How do you access the internet?

  • How confident are you in researching / locating something "new" on the internet?

  • Would you be interested in some basic IT training on a:


  • Do you feel that you would benefit from support in the following areas?

  • Referrals to be made

  • Please provide details of support provided:


How we contact you

  • How should we contact you?


  • 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.