Reference no.

Home Buyer’s Grant

Application Form

A Home Buyer’s Grant can help council tenants in some types of property to buy a home privately. The council will give a cash grant to help you buy a home if you cannot get a mortgage that is large enough. The property you leave will then be used to provide a home for a homeless family.
Please note that we will pay the grant on the day your home purchase is completed. Therefore, the grant cannot be used as part of your deposit.
See the conditions of the scheme for how to qualify.
To apply, complete the form below. Please answer all questions and return the form to the address at the end, enclosing all documents as requested. Please note: the information you give on this form may be used for other council purposes. All documents received will be returned.
1. Details of tenants
This form should be completed by the tenant(s). Please enter both names if you are joint tenants.
Mr/Mrs/
Miss/Ms / Name
in full / Date of
birth
Mr/Mrs/
Miss/Ms / Name
in full / Date of
birth
Daytime telephone number / Person to ask for
Your
address
Postcode
Is this your only home? Yes / No / If no, please give details
2. Your present home
Please tick if your home is a: / House / Flat / Maisonette
How many bedrooms do you have?
If you live in a flat or maisonette, on which floor is the entrance to your home?
Do you have use of a garden? Yes / No
If yes, is it for your use only or is it shared?
Do you have use of a shed? Yes / No / If yes, what is the shed number?
Do you have use of a garage? Yes / No / If yes, what is the garage number?
3. Your tenancy
How long have you been a tenant of this property?
How long have you been a council tenant in any other council property?
Please give details of any previous tenancies
Address / Name of landlord (Council) / From / To
Please give your rent reference number
This number is on your rent card. Do not quote the number 5252652 which is the council’s account number.
How much is your rent
each week? / £ / Do you pay this weekly,
fortnightly or monthly?
4. The people who live with you
Please give details of any children or other people who live with you. Do not include yourself or your partner or joint tenant.
Surname / First Names / Date of birth / Male or
Female / Relationship to tenant(s)
5. Other people who wish to buy with you
Please give details of anyone else who is not a tenant or joint tenant who would share the purchase with you.
Other purchaser 1 / Other purchaser 2 / Other purchaser 3
Name in full
Mr/Mrs/Miss/Ms
Date of birth
Relationship to tenant
Do you currently live / Yes / No / Yes / No / Yes / No
in the property?
If yes, for how long?
6. Your income
Please give details of your income and anyone else sharing the purchase:.
Yourself / Joint tenant or other purchaser / Other purchaser
Name
Occupation
Full or part time?
Name and address of employer
Basic annual income
Guaranteed bonus or regular overtime
Any other income
TOTAL
Please provide proof of your income, for example, your last three pay slips if you are monthly paid, your last six payslips if you are weekly paid or a letter from your employer. Please state your income on an annual basis (weekly x 52 or monthly x 12). If you consider that the total amount shown above does not fairly show your annual pay, please state the actual total and the reason for the difference.
Actual total:
£ per year / Reason:
7. Income from a business
If you or any joint tenant or other purchaser are self employed.
Yourself / Joint tenant or other purchaser / Other purchaser
How long have you been self-employed?
Name and address of business
Type of business
Name and address of accountant

Please provide audited accounts for the last two years.

8. Other income
Please give details of any other sources of income, including pensions, investments etc.
Source of income / Yourself / Joint tenant or other purchaser / Other purchaser
£ per year / £ per year / £ per year
£ per year / £ per year / £ per year
£ per year / £ per year / £ per year
£ per year / £ per year / £ per year

Please provide proof of this other income.

9. Savings
Please give details of any savings.
Yourself / Joint tenant or
other purchaser / Other purchaser
Name
Amount / £ / £ / £
Where is your savings account held?
How much of your savings will be retained to cover legal and moving expenses? We can allow a maximum of £3,000
£
Will you be using other sources of money to pay for your new home? Yes / No
If yes, please state amount / £
Where will this money come from?
Please provide evidence of your savings.
10. COMMITMENTS
Please give details of any financial commitments you have if they are likely to continue for more than 12 months, for example, maintenance payments, loan repayments, hire purchase etc.
Payment For: / Amount Per Month
£ per month
£ per month
£ per month
£ per month

Please provide evidence of your commitments.

11. Declaration
Please read this declaration and sign below. All applicants must sign.

Warning

If you give false information, you may be disqualified and liable to repay any grant given.
I/We certify that, to the best of my/our knowledge, the information given on this form is true.
I/We confirm that we have read the conditions of the Home Buyer’s Grant scheme and accept the conditions under which we may given a Home Buyer’s Grant, in particular:
I/We accept that the council will not be liable for any costs incurred by me/us in connection with the scheme.
I/We accept that the submission of this application form does not automatically entitle me to a grant.
I/We agree to give full vacant possession to the council of my/our present property if a grant is awarded, on the day of completion.
I/We certify that the grant will be used for the purchase of a property for my/our sole occupation and for no other purpose.
Signed Date
Please ensure all applicants have signed.
12. Diversity monitoring
Ealing Council’s services are open to all. We want to remove any possible barriers that may stop people getting their rights. Ealing Council is committed to an Equal Opportunities Policy in its provision of services. As part of this policy all Home Buyer’s Grant applicants are being asked to complete this form. The information provided will be treated in the strictest confidence and used for monitoring purposes only. It will enable Ealing Council to develop procedures to tackle all forms of discrimination in its provision of service.

Age and gender

1. / Please write down the date of birth (month and year only) for each person and if they are male (M) or female (F). / You.………MMYY… M .F . / 2nd person MMYY… M .F .

Your language and ethnicity

2. /

What is your first language?

/ English
Polish
Somali
Hindi
Gujarati
Other: / 



 / Punjabi
Arabic
Farsi
Urdu / 



3. /

Can you understand English?

/ Written? / Yes 
No  / Spoken? / Yes 
No 
4. / What ethnic group do you belong to? /
White
/ British  / Irish  / Polish  / Other 
Mixed
/ White and black Caribbean  / White and black African  / White and Asian  / Other 
Asian/Asian British / Indian  / Pakistani  / Bangladeshi
 / Other 
Black/black British / Caribbean  / Somali  / Other African  / Other 
Other ethnic group / Chinese  / If other ticked please specify:
5. / What is your religion? / Decline to answer.
None
Christian
Buddhist
Other / 


 / Sikh
Muslim
Jewish
Hindu / 



6. / What is your sexual orientation? / Decline to answer
Heterosexual
Lesbian (woman) / 

 / Gay (man)
Bisexual
Transsexual / 


Special needs

7. / Do you have a special need for how we communicate with you? / Large print
Braille / 
 / Audio
No special needs / 

8. /

If you have a disability, please tell us what it is:

/ Wheelchair user
Walking difficulties
Sight problems / 

 / Hearing impediment
Learning difficulties
Mental illness / 


Other:
Confidentiality
This information will be used only for the purpose of diversity monitoring to ensure equality in how we provide housing services.
Thank you for answering these questions. If you think you have been treated unfairly, contact your local Housing Office or your local Councillor.
13. Wanting to move?
Your answers to this section will help us to improve the Home Buyer’s Grant scheme. This will not be used as part of your application.
Why do you want to move? Please tick any boxes that apply.
Location
Crime or vandalism
Racial harassment
Sexual harassment
Violence at home
Neighbours
Noise
Wrong type of property
Overcrowding
No garden, or restricted use
Family reasons
Medical reasons
Service charges
Not willing to buy present home
Other reason (please state)
Have you considered buying your council home? YES / NO
Have you applied for the Right to Buy your home? YES / NO
How did you hear about the Home Buyer’s Grant scheme?
Thank you. Please send the completed form to:
Home Ownership and Leasehold Services

Regeneration and Housing

Perceval House
14-16 Uxbridge Road
Ealing
London W5 2HL
14. Checklist
Before returning your application form and supporting documents, please refer to the following checklist to make sure you haven’t forgotten anything.
I/we have read the conditions of the scheme
I/we have completed all relevant parts of the application form
I/We enclose for each applicant:
If you are monthly paid – last three pay slips
If you are paid weekly – last six payslips or a letter from your employer
If you are self employed – audited accounts for the last two years
Proof of other income
Evidence of savings
Evidence of commitments
All applicants have signed the declaration
‘Ethnic origin’ form has been completed
‘Wanting to move’ form has been completed

HBG/007/04/07