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?

    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

    In order to ensure that this is affordable for you, please include details of your budget below.

    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.