Housing Advice & Homelessness Prevention Service Consent Form

Please do not complete this form unless you have been asked to do so by your Housing Officer
Applicant's Details
1. In order for the council to give a housing advice service to you, we are likely to need to contact other people. We can only do this with your written consent. To give your consent, please complete the online form below.
  
  All requests of information will be made in confidence and only information relating to your current housing circumstances will be asked for. The information we receive will not be used in any other way. If you wish to discuss this matter further please contact your caseworker.
  I/we authorise the Housing Advice and Homelessness Prevention Service to act on my behalf and in my interest in relation to my/our housing situation and related issues.
  
  I/we also authorise the Housing Advice and Homelessness Prevention Service to seek information and copies of relevant documents, and give permission for other parties who hold this information to provide it to the Housing Advice and Homelessness Prevention Service.
  
  I/we further authorise the council to share information with other parties where this could promote the prevention of my/our homelessness .
  
  I/we accept that if the council finds that it is obliged by law to give more information to you as a third party, e.g. to prevent or detect crime or protect children, it will do so.
  
  In doing so I/we consent to the Housing Advice and Homelessness Prevention Service holding on file details of my/our circumstances and other personal details, whether provided by myself/ourselves or others, for the purpose of assisting with my/our housing situation and related issues.
  
  For the purposes of the Data Protection Act 2018, your data controller is the Housing Service of Breckland Council
2. Fields marked with * are required
3. Applicant's name:*
4. Your Email:*
5. Contact telephone number:*
6. National Insurance Number:*
7. I understand that by checking the declaration box below it is classed as my electronic signature and is the legally binding equivalent to my handwritten signature*
8. Are you applying as a couple?*
  
  Yes
  
  No
Partners Details
1. Please ask your partner to provide their details and tick the declaration box to provide consent
2. Partner's name:
3. I understand that by checking the declaration box below it is classed as my electronic signature and is the legally binding equivalent to my handwritten signature
Privacy statement

Breckland Council is collecting this information, via this form, in order to perform this service or function, and if further information is needed in order to do so, you may be contacted using the details provided.

In performing this service, the Council may share your information with other organisations or departments, but only when it is satisfied that it is necessary to perform a public task, or to exercise its statutory duties to do so.

The Council may also share your personal information for the purposes of the prevention, investigation, detection, or prosecution of criminal offences, but will not share your personal information, or use it for any other purpose, unless provided for by law.

More detailed information about the Council's handling of your personal data can be found in our privacy policy.

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Housing Advice & Homelessness Prevention Service Consent Form

Privacy statement

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Housing Advice & Homelessness Prevention Service Consent Form

Privacy statement

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