Thank you for loading up our Rent Repayment Agreement, we hope this service will be helpful to ensure accurate records of when you are due to pay rent.

Please remember there is minimum payment for the accommodation. If you’re unsure of what you need to pay please consult with your support worker / housing worker.

    What is your income?

    How often are you paid?

    Does your income change everytime you are paid?
    YesNo

    I will pay the amount from the rent calculator to pay, plus an agreed amount towards any arrears every:

    Have you informed DWP of any changes?
    YesNo

    Have you done this form with a support worker?
    YesNo

    Have you completed a change of circumstance for Housing Benefit?
    YesNo

    How much is your income?
    If any of the below doesn't apply (for example if you dont pay travel bills), please put "0".
    How much do you spend on Food?
    Travel?
    Leisure
    Other Bills?
    Savings
    You have this much remaining

    Please read the below points.

    • I accept that paying my rent, any arrears, and maintaining benefits I'm entitled to is my responsibility.

    • I understand that if my rent (including payments towards any arrears) isn't paid, there may be disciplinary action taken against me.

    • If there are any changes in my income I will need to do another Rent Repayment Agreement, and also contact DWP and Housing Benefit to inform them of the change in circumstances.

    • A confirmation of this form will be sent to my email address.

    I acknowledge that the above details will be shared within the Housing Team, and that this information can be used to help remind me in regards to rent.

    I agree

    If we see the amount to be too small or too high we would reserve the right to ask you to review it with your support / housing worker to a more reasonable amount.

    Please click the below to submit the above details.