Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Tenant details

  • Sign up completed on:

  • First line of property address

  • Title

  • First name

  • Surname

  • Date of birth

  • Gender

  • Home telephone number

  • Mobile telephone number

  • Work telephone number

  • Email address

  • National Insurance number

  • Marital status

  • Which methods of contact would you prefer?

  • If we need to visit you do you have any special requirements?

  • Agreed password

  • Please state

  • Can you speak English?

  • Can you read English?

  • Nationality

  • Ethnicity

  • Do you have a disability?

  • Tick all applicable

  • If other please state

  • What is your religion?

  • How would you like to be more involved with Housing Services?

  • If other, please state

  • Is this a joint tenancy?

  • Tenant 2 title

  • First name

  • Surname

  • Gender

  • Date of birth

  • Telephone number

  • Email address

  • National Insurance number

  • Is there someone you would like us to contact in an emergency?

  • By providing this information, you authorise us to make contact with the below mentioned in the event of an emergency

  • Name

  • Relationship e.g. carer, son

  • Phone number

  • Would you like to add another household member?

  • Name

  • Gender

  • Relationship to tenant

  • Date of birth

  • Ethnicity

  • Disability

  • Would you like to add another household member?

  • Name

  • Gender

  • Relationship to tenant

  • Ethnicity

  • Date of birth

  • Disability

  • Would you like to add another household member?

  • Name

  • Gender

  • Relationship to tenant

  • Ethnicity

  • Date of birth

  • Disability

  • Would you like to add another household member?

  • Name

  • Gender

  • Relationship to tenant

  • Ethnicity

  • Disability

  • Date of birth

Tenancy induction

  • Tenancy start date

  • Type of tenancy

  • If other please state

  • Total weekly rent

  • Payment method agreed

  • Whilst your Housing Benefit claim is processed you will need to make 'token' payments towards your rent.

  • Lead tenant as agreed to make the following weekly payments during this time:

  • Please supply account details if rent is to be paid by direct debit

  • Name of account holder

  • Account number

  • Branch sort code

  • Full address of your bank or building society

  • Payment date

  • Instruction to your bank or building society - please pay Medway Council Direct Debits from the account detailed subject to the safeguards by the Direct Debit Guarantee. I understand that this instruction may remain with Medway Council and, if so, details passed electronically to my bank/building society.

  • Please sign to confirm Direct Debit payments

  • LGSR date

  • Electrical test date

  • Check the following items once they have been completed/explained to the tenant

  • What is an introductory/secure tenancy?

  • Tenancy Agreement

  • Directed to tenant handbook and information online

  • Repair responsibilities

  • How to order repairs/recharges

  • Rent reviewed each April

  • Rent arrears policy

  • Insurance

  • Alterations/improvements

  • Parking arrangements

  • Pets policy

  • Gardens

  • ASB policy - visitors/children

  • Subletting and lodgers

  • Absence from home

  • Housing Benefit

  • Gas/electricity/stop cock and meter location

  • Minimum lettable standard

  • Do you think the tenant is likely to be vulnerable or in need of tenancy support?

  • Please check all the following that apply

  • Never held a tenancy before

  • Accepted as statutory homeless by Medway Council in past 2 years

  • Anyone known to have a social worker, community psychiatric nurse or other mental health support, drug or alcohol worker

  • Anyone known to have a probation officer or youth offending team worker

  • Refugees

  • People leaving hospital, prison, social care or the forces

  • People with known drug, gambling or alcohol problems

  • People whose learning disability make them vulnerable

  • People whose physical disability or sensory impairment makes them vulnerable

  • Old age pensioners

  • Anyone subject to MAPPA

  • Anyone who has been declared bankrupt

  • People fleeing domestic violence or financial abuse

  • Anyone who has rent arrears of more than 8 weeks

  • People unable to speak English or are illiterate

  • Anyone with severe debt problems

  • Do they have a social worker?

  • Social workers name

  • Confirmation of receipt

    Keys

  • I confirm that I have received the following number of sets of keys for the property

  • I confirm that I have received the following number of communal door keys/fobs

  • Are there any gifted items?

  • Gifted items

    The following items are being offered to you by Medway Council.
    I/we wish to receive these items (as below) free of charge and accept full responsibility for their fittings, maintenance and renewal (any electrical goods will have been PAT tested)

  • Item

  • Location

  • Quantity

  • Would you like to add another gifted item?

  • Item

  • Location

  • Quantity

  • Would you like to add another gifted item?

  • Item

  • Location

  • Quantity

  • Decoration packs

  • Has a decoration pack been issued?

  • I confirm that I have received the following decoration pack

  • I am aware that these vouchers must be used to purchase materials/equipment to redecorate the property

  • Please ask lead tenant to sign to confirm the information in this section

Disclaimers

  • Insurance

    Medway Council is responsible for the buildings of your home only. We strongly recommend that all our tenants insure their home contents and personal possessions.

    The following is a disclaimer, please read carefully and check to confirm each statement.

  • I/we confirm that the Housing Officer has explained the importance of insuring my/our home contents and understand it is my/our responsibility to arrange this

  • I/we confirm that Medway Council has explained the importance of insuring my/our home contents

  • I/we understand that the responsibility to arrange home contents insurance is mine/ours

  • I /we are aware that Medway Council has a special home contents insurance scheme for tenants

  • I/we are happy for a representative from Thistle Insurance to contact me to discuss home contents insurance and to offer impartial advice regarding the special scheme for tenants

  • I/we understand that if I/we do not arrange home contents insurance for my home contents and personal possessions, Medway Council cannot compensate me/us if they are lost, stolen or damaged in any way

  • Welfare Benefits Service

  • Does the tenant require an advice appointment with the Welfare Benefits Service?

  • I/we confirm that I/we have declined an advice appointment with the Welfare Benefits Service

  • Reason

  • Fairer rents

    This is set out in our Rent Setting Policy which can be accessed on line. Please check the following statements to confirm.

  • I/we declare that at the time of signing up for this tenancy, I/we confirm that my/our joint income is less than £60,000 per annum

  • I/we declare that if at any time in the future my/our income rises above £60,000 per annum, I/we will inform Medway Council at the earliest opportunity of this change in circumstances.

  • I/we have been informed that to withhold this information or to fail to inform the authority of any relevant change in circumstances may be an offence for which I/we may be prosecuted

  • Data Protection

    Medway Council, as a Data Controller will process you personal data in accordance with the Data Protection Act 1998 (the "Act"). The Council will ensure that it keeps your personal information accurate and secure to provide you with efficient services. When the information is no longer required, it will be disposed of in a secure matter.
    The Council will only use the information it holds about you for the purpose you provided it and will also only collect the minimum information necessary to fulfil that purpose. Please note, however, that the council is required to share your information on occasion with third parties, in particular where it is required by the law e.g. to agencies that help to reduce crime or investigate fraud.

  • Please check this box to confirm your agreement to the above

  • Authorisation

  • I/we also authorise Medway Council to make any enquiries/act on my/our behalf with reference to my rent arrears/housing matters, both now and in the future

  • I/we understand that this may involve sharing information and receiving information with departments within the Council, including but not limited to Housing Benefit and Social Services teams

  • I/we understand that the Council may also need to share and receive information from third parties for the purposes of pursuing housing related queries such as Benefits Agency, Citizen Advice Bureau, Police, NHS and GPs

  • Overall

    I understand and agree to the above disclaimers around insurance, welfare benefits, fairer rents and data protection and sharing.

  • Lead tenants signature

  • Name

  • Date

  • Witnessed by Housing Officer

  • Name

Office use

  • Check that the following documents have been completed and placed on file

  • Void inspection report/specification

  • Gas LGSR

  • Electrical report/certificate

  • EPC

  • Tenancy agreement

  • CORE form (if required)

  • Tenancy created in Academy/documentation checked by

  • Name

  • Title

  • Date

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.