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Orkney Housing Association
Quality Affordable Homes for Orkney

Online Rented Housing Application Form

This form has to be printed, signed and sent/brought to our office for processing. If you do not have a printer available, you can either come into our office and fill in a form, or call/email us to request that one is mailed out to you to fill in and return.

This form is an application for the Common Housing Register. You will automatically be registered with Orkney Islands Council (OIC) and Orkney Housing Association Ltd (OHAL). If you do not wish to be housed by one of the housing providers please please tick the relevant box:

Would you like to receive information on Low Cost Home Ownership? We will send you further information and an application form.

Would you be interested in a mutual exchange and allow us to give your details to other people who are interested? (Council and Housing Association tenants)?

Included in this pack is:

  • Application Form
  • Ethnic Monitoring Form
  • Orkney Islands Council (OIC) Allocations leaflet
  • Orkney Housing Association Ltd (OHAL) Allocations leaflet

Failure to provide all the information requested will result in a delay to your application being processed. Once we have received your form we will acknowledge receipt within two working days. Once your application from has been assessed we will write to tell you the outcome of your application.

If you have any questions about the form, please contact either OIC or OHAL where a member of staff will be happy to help.

For the purposes of this form Orkney Islands Council will be referred to as OIC and Orkney Housing Association Ltd will be referred to as OHAL.

Question 1

You Joint applicant
Title (Mr, Mrs, Miss, Ms)
Surname
Previous surname(s)
Forename(s)
Date of birth
National Insurance No.
Gender (please tick)
Relationship to applicant N/A

Question 2

Do you require information in another format/language?

If 'Yes' which format/language?

Question 3

Address
You Joint Applicant
(If different)
Postcode
Correspondence address (if different from above)
You Joint Applicant
(If different)
Postcode
Contact details
You Joint Applicant
(If different)
Telephone (home)
Telephone (mobile)
Telephone (work)
E-mail

Question 4

Household members to be housed with you
Surname Forename(s) Date of Birth
Sex Relationship to you (main applicant) Do they live with you?
Add another

Question 5

Contact address of household members to be housed with you
To be filled out if any person listed in Question 4 is not currently living with you

Name
Address
Postcode

Question 6

Other people who live at this address but will NOT be moving with you
To be filled out if you provided an address in Question 5

Surname Forename(s) Date of Birth
Sex Relationship to you (main applicant)
Add another

Question 7

Are you, or anyone who is to be housed with you pregnant?

If 'Yes' please fill out the details below.
Please provide us with a copy of form MAT B1.
It is important that you notify us when the baby is born.

Who is the mother? (name)

When is the baby due?

Question 8

Do you have contact with any children from a previous relationship who will not be housed with you?

If 'No,' go to Question 11. If 'Yes,' please give details

Surname Forename(s) Date of Birth
Sex Relationship to you (main applicant)
Add another

Question 9

Do they stay overnight?

If 'Yes' how many nights per week?

Question 10

Are you unable to have your children stay with you because your current accommodation is unsuitable?

If 'Yes' please state why

Question 11a

Please tick one box that best describes your present accommodation

You Joint Applicant
OIC tenant
OHAL tenant
Any other housing association
Any other local authority
Low-Cost Home Ownership
Owner-occupier
Supported accommodation
Private tenant
Tied accommodation
Homeless accommodation
Living with family/friends
Living with partner
Lodger
Refuge
Hostel
Roofless/no fixed abode
In hospital
In prison
In halls of residence
Subtenant
Other (please specify)

Question 11b

Are you currently a member or a Veteran of the Armed Forces

If a Veteran when did you leave the Armed Forces?

Question 11c

Are you a widow, widower or other partner of service personnel killed in action?

If 'Yes' please provide the date of death

Question 12

Do you or the joint applicant have any current rent arrears with OIC, OHAL or any other social landlord?

Question 13

When did you move into your current accommodation?

Question 14

If you live in rented accommodation, please provide details of your landlord

Name
Address
Postcode

Question 15

Do you have a written lease or agreement with your landlord? Please provide us with a copy of your lease and AT5, if relevant, with your application.

Question 16

What type of property do you live in?

If you live in a flat, which floor do you live on?

Question 17

How many bedrooms are there in your current home?

Question 18

Does the accommodation have:

Yes No Shared
Bath/Shower
Kitchen
Living-room
Cooking facilities
Inside flushing toilet
Wash hand basin
Piped water supply
Hot water
Mains electricity
Central heating
Central heating - Please detail:
Dampness
Water penetration
Dangerous wiring
Other (please specify)

Question 19

Reasons for applying for social housing (please tick all that apply)

To gain secure accommodation
To move to a larger property
To move to a smaller property
Employment reasons
Social/Medical reasons
Relationship breakdown
Suffering from harassment/violence
To support a relative
To receive support from a relative
Fleeing domestic abuse
Property in poor condition
To move to another area
Bereavement
Financial reasons
Independence
Leaving Armed Forces/other tied accommodation
No permanent address
Other (please specify)

Please provide further information on any of the above

Question 20

Does a member of your household suffer from a medical condition that is being affected by your current accommodation?

If 'Yes' please provide the name of the person who is affected

Condition

How is the condition affected by your current accommodation?

Question 21a

Do you require to move into or remain in the area of your choice for support without which you would be unable to live independently?

If 'Yes' please provide the name and address of the person who will provide the support.

Name
Address
Postcode

Question 21b

Do you have difficulty in travelling to your work from your current housing location?

If 'Yes' please specify

Question 22

Are you employed in your area choice and require to remain within that area to continue in this employment?

Question 23

Do you require housing support to help you maintain a tenancy e.g. home support worker, home carer?

If 'Yes' please give details of the support required

Question 24

Do you have a care manager, social worker or occupational therapist?

If 'Yes' please give give the their name and address

Name
Address
Postcode

Question 25

Are you threatened with homelessness (a person is defined as being threatened with homelessness if he or she is likely to become homeless within two months)?
If you are threatened with homelessness, please provide copies of any documents such as a Notice to Quit and/or Notice of Intention to Repossess.

If 'Yes', by what date are you expected to leave?

Why do you have to leave?

Question 26a (Main Applicant)

Please provide details below of all addresses over the last 5 years

Previous Address
Postcode
Date from
Date to
Were you a tenant/lodger/owner/living with family etc. (refer to Q11)
Name of Landlord (if applicable)
Address of Landlord (if applicable)
Postcode of Landlord (if applicable)
Reason for leaving
Add another

Question 26b (Joint Applicant)

Please provide details below of all addresses over the last 5 years

Previous Address
Postcode
Date from
Date to
Were you a tenant/lodger/owner/living with family etc. (refer to Q11)
Name of Landlord (if applicable)
Address of Landlord (if applicable)
Postcode of Landlord (if applicable)
Reason for leaving
Add another

Question 27

Have you, or anyone you want to live with you, been evicted for anti-social behaviour or been served with an anti-social behaviour order (ASBO)?

If 'Yes' please give details including the name of the person, date ASBO was granted, and the name and address of your landlord at the time the order was served

Person's name
Date of ASBO
Landlord name
Landlord address
Landlord postcode

Question 28

Are you, or anyone to be rehoused with you, required to register with the police under the Sexual Offenders Act 2003 or any other reason?

If 'Yes' please give details of the person registered

Person's name
Date of Birth

Question 29

Do you and everyone to be housed with you have the right to reside in the UK?

If 'No' please give details

Question 30 - Please complete the area(s) you wish to be re-housed in order of preference

Please enter between one and a maximum of 4 areas you would consider.
Please note 'anywhere' cannot be accepted.
See the property map for locations of where OIC and OHAL currently have properties. If you are looking for accommodation in an area where we do not have any properties, you can still specify this as an area choice and this information will be used to measure demand for future building projects.

1st choice
2nd choice
3rd choice
4th choice

Question 31

What type of property would you consider? Please tick all that apply

Question 32

Do you require:

There may be medical criteria to qualify for these housing types

Question 33

Please provide any additional information you feel is relevant to your application for housing

Declaration and Signature

Please ensure you (and the joint applicant) print and sign both parts of the declaration, then either post it or bring it in to the office where we will then process your application.

Print, sign and return