Housing Benefit and Council Tax Support self-employed income form 1Using the form2Declaration3About you4About your business5About your partnership6About your business (continued)7Your accounts8Your income9Your outgoings10Other outgoings11Upload proof If you want to claim Housing Benefit or Council Tax Support, fill in this form to tell us about any self-employment. Please be aware, if the company is a Limited Company and you are an employee, for example a director or secretary, you are employed and will need to provide pay slips or accounts showing directors wages. You need to fill in one of these forms for each business you are involved in. Please note: private expenses can’t be included as a business expense you can’t include losses that have, or will be, replaced from insurance claims you can’t include losses that are a result of expansion. Income from self-employment is usually calculated on an annual basis. You are expected to budget for any variation in your income for trading activities during the year. You will not need to report monthly or seasonal changes in your earnings which are expected as part of your normal trading activity. We will contact you every year and request that you provide your up to date accounts to ensure your claim is up to date. You only need to report changes in your circumstances where there has been a significant change in the way your business operates, for example if you: increase or reduce the hours your business trades for on a permanent basis lose or gain a new contract This form will ask you to provide your details including National Insurance number details of your business including the name, type, when you started the business, a brief description of your normal daily work and the number of hours you usually work per week if you pay into a private pension scheme, how much and how often you pay, and proof of this if your business is a partnership, the number of partners and their names and addresses, the percentage of the profit that is yours, and how much they get paid (if they're on the payroll) if you have audited accounts, a copy of your latest profit and loss account details of your accountant (if you have one) if you don't have audited accounts, a full breakdown of the income and outgoings of your business (if you have only just started trading, please provide estimated accounts for at least your first three months trading). Please have this information ready as pages time-out after one hour. Please do not use your browser’s back button – if you need to go to a previous page click on the ‘previous’ button at the bottom of each page. Privacy Statement Dover District Council is a Data Controller under GDPR. In submitting this form we will collect and process your personal data. For information about your rights and how the Council uses your data, please view our Corporate and relevant service privacy notice which can be found on our Privacy page. DeclarationPlease check the box below to confirm that you have read, understand and agree to the following statements before completing this form: I confirm the details I will give are correct and that the documents I will upload as proof are original copies and have not been edited in any way. I understand my assessment will be based on my latest accounts (or statement of account) and will be reassessed when the appropriate years accounts are available. I understand I must provide my latest accounts as soon as they are available to me. If I do not have accounts prepared by an accountant I must provide an annual statement of account. I will notify you straight away if my income changes significantly from what I have declared on this form. I understand that if I give information that is false this could lead to a penalty or legal proceedings being taken against me. I understand my data may be shared with other departments as permitted by law. Declaration(Required) I understand and accept the above declaration About youTitle (for example Mr, Mrs, Ms, Miss)(Required)First name(Required)Last name(Required)Contact phone number(Required)We ask for your phone number so we can call you or send you important text messages (if we need to) about your claimHousing Benefit or Council Tax Support reference number (if known)National Insurance number(Required)Email address(Required)We will use your email address to send the receipt of your form, including the form reference number. This may include personal data. We will also use your email address to contact you about your benefit claim and Council Tax account. Enter email address Confirm email address Would you like to receive your Housing Benefit, Council Tax Support notifications and Council Tax bills by email?(Required)You can receive your Housing Benefit, Council Tax Support notifications and Council Tax bills by email rather than post. We will send all future Housing Benefit and Council Tax Support notification letters and Council Tax bills to the email address you have given above. If you change your email address you must let us know straight away. You can opt out of this at any time at dover.gov.uk/paperless Yes No About your addressAddress(Required) Address line 1 Address line 2 Town or city Postcode About your businessHow many businesses are you involved in?(Required)Please fill in one of these forms for each business.What is the name and address of your business (including postcode)?(Required)What type of business is it?(Required)Please give a brief description of your normal daily work(Required)When did you start your business?(Required)DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Average hours worked per week(Required)What is the start date of your current financial year?(Required)DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Do you pay into a private pension scheme?(Required)If ‘Yes’ you will need to provide proof Yes No Private pension schemeHow much and how often?(Required)Is your business a partnership?(Required) Yes No Are you a seasonal worker?(Required) Yes No Seasonal workerWhen is your busiest period of trading?(Required)Please note that you are expected to budget annually and cannot claim just for periods of low tradeFromTo About your partnershipHow many partners are there?(Required)What percentage of the profit is yours?(Required)What are their names and addresses?(Required)Are the partners on the payroll of the business?(Required) Yes No How much do they get paid?(Required) About your business (continued)Are you completing this form as a result of a request to review your circumstances?(Required) Yes No Review of circumstancesHas there been any change in your trading activity since you last declared your income?(Required) Yes No What has changedPlease tell us what has changed and when the change happened(Required) Your accountsDo you have audited accounts?(Required) Yes No Please upload a copy of your latest profit and loss account(Required) Drop files here or Select files Accepted file types: txt, pdf, doc, docx, rtf, jpg, jpeg, tif, tiff, bmp, png, xls, xlsx, Max. file size: 15 MB, Max. files: 5. Do you have an accountant?(Required) Yes No About your accountantAccountant's full name(Required)Accountant's telephone number(Required)Accountant's address(Required) Your incomePlease give us details of your business income and outgoings for a period of trading. The period you tell us about must not cover more than one year. If you have only just started trading, please provide estimated accounts for at least your first three months trading. You must provide actual accounts after you have worked 13 weeks and then at 26 weeks. What is the start date for this period of trading?The period you tell us about must not cover more than one yearDayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920What is the end date for this period of trading?(Required)DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Sales, takings and income from business activities only(Required)Commission, interest, etc(Required)Business loans and incentives(Required)Any other monies receivedExplanation of any other monies received(Required)Opening stock(Required)Stock purchased(Required)Closing stock(Required) Your outgoingsThis should be for the same time period as the details given for the business incomes. You may be asked to provide proof of any expenses you list. Any proof must be in a relevant order: date/invoice number/type of expense. *Proven bad debts are money owed to you that have been written off for reasons such as insolvency or death. Some items detailed below may be allowed by HMRC, but are not allowed for our purposes. Accomodation – type of outgoingBusiness insurance (excluding vehicle insurance)Total spent (£0.00)Amount for non-business use (£0.00)Business ratesTotal spent (£0.00)Amount for non-business use (£0.00)Cleaning and maintenance of business premises (unless responsibility of landlord)Total spent (£0.00)Amount for non-business use (£0.00)Heating and lightingTotal spent (£0.00)Amount for non-business use (£0.00)Water ratesTotal spent (£0.00)Amount for non-business use (£0.00)Vehicle – type of outgoingFuelTotal spent (£0.00)Amount for non-business use (£0.00)InsuranceTotal spent (£0.00)Amount for non-business use (£0.00)Maintenance/repairsTotal spent (£0.00)Amount for non-business use (£0.00)Wages – type of outgoingGross wages paid to yourself or drawingsTotal spent (£0.00)Amount for non-business use (£0.00)Gross wages paid to your spouse or partnerTotal spent (£0.00)Amount for non-business use (£0.00)Gross wages paid to othersTotal spent (£0.00)Amount for non-business use (£0.00)Taxi – type of outgoingMedical expensesTotal spent (£0.00)Amount for non-business use (£0.00)Circuit/licence fees (initial and renewals)Total spent (£0.00)Amount for non-business use (£0.00)DBS (formerly CRB) checkTotal spent (£0.00)Amount for non-business use (£0.00) About your other outgoingsThis should be for the same time period as the details given for the business incomes. You may be asked to provide proof of any expenses you list. Any proof must be in a relevant order: date/invoice number/type of expense. *Proven bad debts are money owed to you that have been written off for reasons such as insolvency or death. Some items detailed below may be allowed by HMRC, but are not allowed for our purposes. Type of outgoingAccountancy chargesTotal spent (£0.00)Amount for non-business use (£0.00)AdvertisingTotal spent (£0.00)Amount for non-business use (£0.00)Business bank account chargesTotal spent (£0.00)Amount for non-business use (£0.00)Business entertainmentTotal spent (£0.00)Amount for non-business use (£0.00)Debt recovery costs, bailiff/court feesTotal spent (£0.00)Amount for non-business use (£0.00)DepreciationTotal spent (£0.00)Amount for non-business use (£0.00)Equipment rentalTotal spent (£0.00)Amount for non-business use (£0.00)Interest payments on business loans/consumer credit chargesTotal spent (£0.00)Amount for non-business use (£0.00)Legal feesTotal spent (£0.00)Amount for non-business use (£0.00)New equipment to improve or expand your businessTotal spent (£0.00)Amount for non-business use (£0.00)Postage/delivery costsTotal spent (£0.00)Amount for non-business use (£0.00)Printing and stationeryTotal spent (£0.00)Amount for non-business use (£0.00)Proven bad debts*Total spent (£0.00)Amount for non-business use (£0.00)Repair, replacement and maintenance of assetsTotal spent (£0.00)Amount for non-business use (£0.00)Special clothingTotal spent (£0.00)Amount for non-business use (£0.00)SubsistenceTotal spent (£0.00)Amount for non-business use (£0.00)TelephoneTotal spent (£0.00)Amount for non-business use (£0.00)VAT paid outTotal spent (£0.00)Amount for non-business use (£0.00)Other (please give details below)Total spent (£0.00)Amount for non-business use (£0.00)Other (please give details below)Total spent (£0.00)Amount for non-business use (£0.00)Other (please give details below)Total spent (£0.00)Amount for non-business use (£0.00)Please give details of any other outgoings Upload proofPlease upload any proof that we have asked for in this form, for example if you pay into a private pension scheme, please provide proof of this. If you are uploading photographs of documents, please make sure you take a photo of every relevant page, that they are clear and that any words or figures can be easily read. If you have no proof to upload, please leave this page blank. Upload your proof Drop files here or Select files Accepted file types: txt, pdf, doc, docx, rtf, jpg, jpeg, tif, tiff, bmp, png, xls, xlsx, Max. file size: 15 MB, Max. files: 5. Other informationPlease use this box to tell us any other informationIf you have no further information to give us, leave the box blank
