Your National Insurance Number *
About your home What type of property do you live in
Please select House Bungalow Flat Bedsit Maisonette What floor do you live on, if you live in a flat, bedsit or maisonette:
Who is your landlord?
Please select Bromford Housing Group Heantun Housing Midland Heart Walsall Housing Group Other Housing Association City of Wolverhampton Council Other council Do you have any pets? * If you have pets, please tell us which type of animal it is:
If you live in a flat, bedsit or maisonette, is there a lift in your block? * Yes No How many bedrooms are there in the property *
Please select 1 2 3 4 5 6 Does the property have any adaptations? * Yes No If the property has adaptations, what are they?
People living with you
Please tell us about the people living with you, we'll need their
name date of birth gender national insurance number relationship to you. About the people moving with you:
Details about the person you are exchanging with What is their first name *
What is their last name *
What is their address *
What is their contact telephone number *
Who is their landlord?
Please select Bromford Housing Group Heantun Housing Midland Heart Walsall Housing Group City of Wolverhampton Council Other council Your declaration This form has been completed honestly to the best of my/our knowledge. I/we give permission for Wolverhampton Homes to carry out checks on the information given to confirm that the details supplied are correct. *
I/We understand that no arrangements should be made to move until I/we have received confirmation from Wolverhampton Homes, should I/we do so, I/we understand that Wolverhampton Homes will consider enforcement action to end our tenancy. *