Housing SA

Assistance with Overcrowding

03/2014

1 | DCSI –Assistance with Overcrowding application form

Property details

AddressPostcode

1 | DCSI –Assistance with Overcrowding application form

Telephone Number

Customer Number

1 | DCSI –Assistance with Overcrowding application form

Household details

1 | DCSI –Assistance with Overcrowding application form

Full name

Relationship to tenant

Age

1 | DCSI –Assistance with Overcrowding application form

Tenant

Why do you need larger accommodation and for whom?

Declaration To be read and signed by the tenant.
I declare that the information provided in this request is true and correct
I undertake to notify Housing SA immediately if there are any changes in my household circumstances.
SIGNATURE / DATE
Conditions / Assistance will only be provided if the intended occupant is a member of the tenant’s household who normally resides with the tenant on a permanent basis.
Acceptance of this form does not guarantee that Housing SA will provide assistance.

1 | DCSI –Assistance with Overcrowding application form

HOUSING SA OFFICE USE ONLY / CONDITIONS OF USE
Housing Officer’s Report: /
  1. Portable buildings are subject to the same Conditions of Tenancy applicable to Housing SA rental houses.
  2. A portable building is to be used for accommodation purposes only and must not be used as a playroom, workshop, storage room or for any other purpose.
  3. A portable building must only be used to accommodate an occupant who is 13 years of age or older and who normally resides with the tenant on a permanent basis.
  4. Naked lights or appliances operated by burning fuel must not be used in or about the portable building.
  5. The area beneath the portable building, in the immediate vicinity of the portable building and between the portable building and any adjacent fence must remain free from obstruction by any type of material. All grass and any flammable material within these areas must be permanently removed.
  6. The tenant will remain responsible for the custody and care of the portable building until it is removed by Housing SA.
  7. The tenant will ensure that the portable building is not obstructed by any object whilst it is on the premises and that it is ready to be removed by Housing SA at any time.
  8. The tenant will immediately advise Housing SA of any change in their household circumstances.
  1. Housing SA will review the tenant’s ongoing need for the portable building during each Home Visit or upon advice of a change in household circumstances and may remove the portable building after providing the tenant with no less than 28 days notice in writing.

Is this application a priority? YesNo
Housing Officer’s preliminary assessment:
  1. Does the site have:

  • Level or near level site?

YesNo
  • At least 20 square meters yard space (approx.. 6 steps from house to fence)?

YesNo
  1. Is the yard accessible so that if a PSO is provided, it can be lifted or manoeuvred into position?

YesNo
Date registered
Housing Officer signature
USER ID
Approved / Not approved
Team Leader / Manager
USER ID
Date received
Forwarded to
USER ID / Date

1 | DCSI –Assistance with Overcrowding application form