About you
Telephone numbers
About your business
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About the business income
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Income and expenditure

Please complete all of the fields below, otherwise your application will not be valid.

If existing business with no audited accounts - Please provide earnings and expenses below.

Expenses - All expenses should be for the same period of projected earnings
Cost of Sales (For existing business only)
What is your rent? (Premises/Proportion of your home rent
Business Rates
Heating and Lighting
Cleaning
Telephone
Business Insurance
Advertising/Essential Publications
Printing
Stationery
Bank Charges
Postage/Packing
Interest Payments on Business Loans
Repair or replacement of business assets (existing business only)
Leasing Charges
Business entertainment
Travel
Bad debt
Please give details.
Motoring expenses

You may be required to provide proof of any expenses items listed. The Housing Benefit office will contact you if necessary.

Wages paid out
Period these expenses cover
Declaration

Please read this declaration carefully before you sign and date it.

I understand the following:

  • If I give information that is incorrect or incomplete, you may take action against me.
  • You will use the information I have provided to process my claim for Housing Benefit or Council Tax Support, or both.
  • You may check some of the information with other sources within the council, rent offices, and other councils.You will also check with the Home Office and other government organisations.
  • You may use any information I have provided in connection with this and any other claim for benefits that I have made or may make.
  • You may give some information to other government organisations, if the law allows this.

I know I must let Lambeth Revenues and Benefits know, within one calendar month about any changes in my circumstances which might affect my claim.

I declare the information I have given on this form is correct and complete.