Housing benefit supported accommodation landlord rent schedule 1Using the form2About you the landlord3About the scheme4Facilities, amenities and charges5Intensive housing management6Ineligible service charges7Care, support and supervision8Declaration9Other information The form must be completed by the landlord. This form will ask you to provide your details scheme information weekly charges including lease/rent gross yield %, sinking fund, facilities and amenities, void state % intensive housing management breakdown ineligible service charges details of the care, support and supervision provide and any charges. Please have this information ready as pages time-out after one hour. Do not use your browser 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. About you the landlordTitle (for example Mr, Mrs, Ms, Miss)(Required)First name(Required)Last name(Required)Company name (if applciable)Contact phone number(Required)Email address(Required) Enter email address Confirm email address Address(Required) Address line 1 Address line 2 Town or city Postcode About the schemeScheme name(Required)Scheme address(Required) Address line 1 Address line 2 Town or city Postcode Number of tenants in the scheme?(Required)Date the rent is effective form?(Required)DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920About the rent (per week per tenant)Lease/rent gross yield %(Required)Lease/rent weekly cost(Required)(per week per tenant)Sinking fund(Required)Weekly cost (per week per tenant)Please confirm what the sinking fund covers(Required)Development/legal costs(Required)Weekly cost (per week per tenant)Landlord's buildings and contents insurance(Required)Weekly cost (per week per tenant)Any other core rent costs, for example lending repayments(Required)Weekly cost (per week per tenant)Please provide a breakdown of any other payments(Required) About the facilities, amenities and related chargesWeekly cost £0.00Fire and safety equipment servicing and replacement(Required)Day to day repairs and maintenance(Required)Statutory maintenance/servicing tests(Required)Maintenance/servicing contracts on heating/electrical system(Required)Door entry and CCTV security systems(Required)Water safety inspections and monitoring(Required)Planned maintenance (please supply breakdown)(Required)Please provide a breakdown of what the planned maintenance covers(Required)Refuse disposal and pest control(Required)Night security(Required)Gardening(Required)Window cleaning(Required)Replacement of communal furnishings(Required)Replacement of communual white goods(Required)Provision of flooring & curtains(Required)Provision of communal telephone(Required)Provision of furniture/equipment for tenants own areas(Required)Internal decoration(Required)External redecoration(Required)External Cleaning – communal areas(Required)Heat and light – communal areas only(Required)Communal water charges(Required)Council Tax(Required)Management costs weekly total (breakdown required), if applicable(Required)Please provide a breakdown of management costs(Required)Facilities, amenities and related charges (continued)Void %(Required)Weekly cost £0.00(Required) Intensive housing management breakdownWeekly cost £0.00Rent collection/arrears maintenance(Required)Administration and maintenance of tenancy agreements(Required)Liaison with other agencies(Required)Concierge duties and access controls(Required)Providing information on tenancy related matters(Required)Staff training relating to housing management(Required)Tenant consultation on tenancy related matters(Required)Other weekly charges total (breakdown required), if applicable(Required)Please provide a breakdown of other intensive housing management charges(Required) About the ineligible service chargesWeekly cost £0.00Personal heat and light(Required)Water rates(Required)Personal cleaning(Required)Management of ineligible services(Required)TV licence(Required)Emergency alarm system(Required)Non communal window cleaning(Required)Non communal gardening(Required)Meals(Required)Other weekly charges total (breakdown required)(Required)Please provide a breakdown of other Ineligible service charges(Required) About the care, support and supervisionWho is responsible for ensuring that care, support, supervision is provided?(Required)Please select all that apply Landlord KCC NHS Other Please tell us who is responsible for ensuring that care, support, supervision is provided?(Required)Who is the care, support or supervision provider?(Required)Who pays the care, support and supervision charges?(Required)Care, support and supervision chargesPlease tell us the weekly charge and hours for the following24 hour sleep-in support weekly charge(Required)24 hour sleep-in support weekly hours(Required)Intensive high-level support weekly charge(Required)Intensive high-level support weekly hours(Required)Life skills weekly charge(Required)Life skills weekly hours(Required)Sheltered housing weekly charge(Required)Sheltered housing weekly hours(Required)Occasional support as and when required weekly charge(Required)Occasional support as and when required weekly hours(Required)Support for general needs weekly charge(Required)Support for general needs weekly hours(Required)Medical treatment weekly charge(Required)Medical treatment weekly hours(Required)Nursing care weekly charge(Required)Nursing care weekly hours(Required)Physiotherapy weekly charge(Required)Physiotherapy weekly hours(Required)Day to day help (shopping, bathing, dressing) weekly charge(Required)Day to day help (shopping, bathing, dressing) weekly hours(Required)Child care activities weekly charge(Required)Child care activities weekly hours(Required)Providing education and training weekly charge(Required)Providing education and training weekly hours(Required)Welfare benefit advice other than HB weekly charge(Required)Welfare benefit advice other than HB weekly hours(Required)Debt advice (not related to rent arrears) weekly charge(Required)Debt advice (not related to rent arrears) weekly hours(Required)Legal advice weekly charge(Required)Legal advice weekly hours(Required)Organising communal activities weekly charge(Required)Organising communal activities weekly hours(Required)Therapy and advice weekly charge(Required)Therapy and advice weekly hours(Required)Support plans weekly charge(Required)Support plans weekly hours(Required)Daily welfare checks weekly charge(Required)Daily welfare checks weekly hours(Required)Other weekly charges total (breakdown required) weekly charge(Required)Other weekly charges total (breakdown required) weekly hours(Required)Please provide a breakdown of the other care, support and supervision charges(Required) DeclarationPlease check the box below to confirm that you have read, understand and agree to the following statements: I confirm the details I have given are correct and true. I confirm that I will notify you of any relevant changes straight away. 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 Total weekly charges are listed below:Rent per week per tenant – total weekly charges:Facilities, amenities and related charges – total weekly charges:Intensive housing management breakdown – total weekly charges:Ineligible service charges – total weekly charges:Care, support and supervision charges – total weekly charges:Total weekly charges:Other informationPlease use this box to tell us any other informationIf you have no further information to give us, leave the box blank
