Mutual Exchange Application Form

About You - Tenant 1

House name or number

Street Name

Town/Village

Postcode

Title

Mrs

Miss

First Name

Middle Name

Surname

Date of Birth

National Insurance No

Phone Number

Email Address

About You - Tenant 1

About You - Tenant 2

Title

First Name

Middle Name

Surname

Date of Birth

National Insurance No

Phone Number

Email Address

Reason for move

Other household members - 1

Full Name

Date of birth

Relationship to you

Other household members - 2

Full Name

Date of birth

Relationship to you

Other household members - 3

Full Name

Date of birth

Relationship to you

Other household members - 4

Full Name

Date of birth

Relationship to you

Other household members - 5

Full Name

Date of birth

Relationship to you

Other household members - 6

Full Name

Date of birth

Relationship to you

Household Information - Pregnancy

Is anyone in your household pregnant?

Yes

If so who?

Due Date?

About your current home

Tenancy start date

Type of Tenancy

Property Type

Floor Level

No of bedrooms

Have you made any alterations to the property? Please give details

Details of the person you wish to exchange with

Title

Mrs

Miss

First Name & Middle Name

Phone number

Email Address

About their property (the property you wish to move to)

House No or Name

Street Name

Town/Village

Postcode

Property Type (House/Flat/Bungalow)

No of Bedrooms

Landlord Details - for your potential exchange partner

Name of Landlord

Office Address

Name of Housing Officer

Contact Number

Email Address

Declaration

Each applicant must accept full responsibility for the correctness of all the information given on the application form and/or at interview and for informing the Housing Officer of every change of circumstances. If a further exchange is completed on the b

I have read the above statement and I accept and understand the requirement to give honest and accurate information and the consequences for not doing so if my application is accepted.

I certify, that to the best of my knowledge, the information I have given on this pro-forma is true. I will advise the Council in writing of any change of circumstances as soon as I am able.

I understand as I am completing this form online, I am required to upload Photo ID (Driving Licence or Passport)

This application for exchange is part of a

Two way exchange

Three way exchange

Four Way Exchange

Five Way Exchange

Six Way Exchange

Upload diagram of exchange (if more that two exchange partners)

I agree to Privacy Policy

Our Privacy Notice

Clear Signature

Upload Photo ID (Driving Licence or Passport)

Report, Request, Apply

Mutual Exchange Application Form