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SECTION 1 – YOUR HOUSEHOLD

FIRST APPLICANT
(if you have lived elsewhere in the last three years, please list all of your previous addresses after your current address here)
SECOND APPLICANT
(if you have lived elsewhere in the last three years, please list all of your previous addresses after your current address here)

SECTION 1 – YOUR EMPLOYMENT

FIRST APPLICANT
(if you are not working please indicate; retired, early retirement on health grounds etc.)
(please specify if self-employed)
SECOND APPLICANT
(if you are not working please indicate; retired, early retirement on health grounds etc.)
(please specify if self-employed)

SECTION 1 – MOD PERSONNEL ONLY

If you are a serving member of UK’s Armed Forces please complete this section

FIRST APPLICANT
SECOND APPLICANT

SECTION 1 – OTHER MEMBERS OF YOUR INTENDED HOUSEHOLD

If you are a serving member of UK’s Armed Forces please complete this section

Please include full name, relationship status and state whether in full-time education, working, etc.

Person 1

Person 2

Person 3

Person 4

(If yes, please state who and due date)

SECTION 2 – YOUR CURRENT HOUSING AND YOUR HOUSING NEEDS

FIRST APPLICANT
£
£
(Please tick all that apply)
(Please tick all that apply)
(If you are a council, housing association or private tenant, please give the name, address, telephone number of your landlord and if applicable the name of your Housing Officer)
(If yes, please specify which one and your reference number if known)
(For example: Require a ground floor apartment due to restricted mobility. If yes, please state what your specific needs are)
SECOND APPLICANT
£
£
(Please tick all that apply)
(Please tick all that apply)
(If you are a council, housing association or private tenant, please give the name, address, telephone number of your landlord and if applicable the name of your Housing Officer)
(If yes, please specify which one and your reference number if known)
(For example: Require a ground floor apartment due to restricted mobility. If yes, please state what your specific needs are)

SECTION 3 – INCOME AND SAVINGS

FIRST APPLICANT
Stamp Duty (if applicable) is not included in this amount
(Exclude overtime and bonuses but include pensions)
(For example: child maintenance)
(For example: child maintenance)
Working Tax Credits / Child Tax Credits / Child Benefit / Disability Living Allowance / Guaranteed Maintenance Income / Other (please state)
SECOND APPLICANT
Stamp Duty (if applicable) is not included in this amount
(Exclude overtime and bonuses but include pensions)
(For example: child maintenance)
(For example: child maintenance)
Working Tax Credits / Child Tax Credits / Child Benefit / Disability Living Allowance / Guaranteed Maintenance Income / Other (please state)

SECTION 4 – DECLARATION

FIRST APPLICANT
Name of the person / Position / Relationship / Name of the Registered Provider
SECOND APPLICANT
Name of the person / Position / Relationship / Name of the Registered Provider

Hyatt Homes will only use your personal data for the purpose of processing your application for housing and will hold your information in accordance with the Data Protection Act 1998.
All information you give to us on this application form (and information resulting from contact with your landlord and/or employer) may be shared with the same only in relationship to this application.
Data will be treated in the strictest confidence. We reserve the right to take up any references relating to applicants as we consider it necessary and may search the files of any credit reference agency, which will keep a record of any such request.
We must protect the public funds we handle and so may use the information you have provided on this form to prevent
and detect fraud. Under section 29(3) of the Data Protection Act 1998 the information may be disclosed for the purpose of crime prevention and detection. Sensitive personal data such as racial or ethnic origin, offences (including alleged offences) and physical and mental disabilities are required under the Equal Opportunities monitoring statute.
We may also share this information for the same purposes with other organisations and handle public funds. The information may be used for statistical surveys, which means we may pass this information in confidence to the Homes and Communities Agency and agencies working on our and their behalf.
Declaration: It is a criminal offence to knowingly or recklessly make a false declaration or withhold information reasonably required in connection with your application.
I/we have read the above and confirm that I/we have provided accurate and up-to-date information relating to my/our application for home ownership. I/we understand that if it is found that false information has been given to obtain housing either knowingly or recklessly, appropriate legal action may
be taken and the Registered and/or Local Authority may seek possession of any leasehold tenancy granted. (Translation service is available if required.)
I/we understand that as a council, housing association or other public sector tenant, I/we will be required to give up my/our rented home on the day of completion if I/we buy a home through this application.
I/we authorise my/our landlord(s) to supply a rent and/or tenancy reference to Hyatt Homes in support of my application.
I/we authorise my/our employer(s) to disclose to Hyatt Homes any information relevant to this application.

Please check you have filled in all sections of this application form.

FIRST APPLICANT
SECOND APPLICANT

SECTION 5 – EQUAL OPPORTUNITIES

In order to ensure all applicants are treated fairly, could you please provide the following information about the first and second applicant. If you do not wish to provide the information, please tick ‘prefer not to say’.

FIRST APPLICANT
(Please tick all that are relevant)
SECOND APPLICANT
(Please tick all that are relevant)

SECTION 6 – WHERE DID YOU HEAR ABOUT HYATT HOMES?