Discretionary Housing Payments (DHP)Discretionary Housing Payments may be claimed if you receive housing benefit or housing costs within your Universal Credit, but are having difficulty paying the rest of your rent yourself. For more information on DHP and what you can spend the payment on please visit our Discretionary Housing Payment page. You will be asked for details of your income and outgoings. You should send with your application copies of relevant bills or bank statements. Please also provide any information about your circumstances that make things difficult for you financially. Please provide all details within seven days of the date of the request or a decision will have to be made based on the available information. Council Tax Support Exceptional Hardship SchemeIf you want us to consider an exceptional hardship payment to help with your council tax you must be the liable person at the address and you must be in receipt of council tax support. You will be asked for details of your income and outgoings. You should send with your application copies of relevant bills or bank statements. You can upload these documents on this form when requested. Please also provide any information about your circumstances that make things difficult for you financially. Please provide all details within seven days of the date of the request or a decision will have to be made based on the available information. Your details Full name * Address line 1 * Address line 2 Town/city * Postcode * Date of birth 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Please enter your date of birth, for example 12/01/12 month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Please enter your date of birth, for example 12/01/12 year 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 National insurance number * Telephone number Email address * Housing Benefit reference number What date do you want your Discretionary Housing Payment to start? Living Arrangements Does anyone else live with you? * Yes No If yes, please give their details below Name Date of Birth Relationship to you Name Date of Birth Relationship to you Do you have rent arrears? Do you have rent arrears? Yes No If yes, how much and for what period? Please upload your most recent rent statement Are you about to be evicted? Yes No Please upload all notices and eviction letters/court letters Please upload all notices and eviction letters/court letters We will use and keep your personal information safe and secure and will only keep this data as long as is necessary. This will assist us in processing your Discretionary Housing Payment and Council Tax Support Exceptional Hardship form in a manner compatible with the General Data Protection Regulation (GDPR). Any disclosures or sharing of information will only take place where required or permitted by law. For further information please see our privacy notice.