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

Is there any extra information you would like to pass on?

I accept my responsibility to pay this rent and, any arrears, in accordance with the repayment schedule detailed above, and to do everything required to maintain any benefits I am entitled to and are claiming. Otherwise, I may have disciplinary action (including warnings and eventually the termination of my license) taken against me by Exeter YMCA.

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.

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

Please click the below to submit the above details.