Let us know if someone will be away from home for more than four weeks 1Using the form2Declaration3About you4Who will be away5Other information If you get Housing Benefit and/or Council Tax Support and you or anyone in your household will be away from your home for more than four weeks, you need to let us know. Use this form to tell us that you or someone in your household will be away from your home. This form will ask you to provide your details including National Insurance number whether the person’s time away will be within or outside of Great Britain If their time away will be outside of Great Britain, the country or region that they will be visiting the reason they will be away from home the date they will be going and the date they will return home. 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. 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 on this form will be 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 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 claimEmail 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 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 Your address(Required) Address line 1 Address line 2 Town or city Postcode Housing Benefit or Council Tax Support reference number (if known)National Insurance number(Required) About the person who will be away from homeName of the person who will be away from home(Required)Is this person going to be away from Great Britain?Great Britain includes England, Scotland and Wales. Great Britain does NOT include Northern Ireland, the Channel Islands or the Isle of Man Yes, they’re going outside of Great Britain No, they’re staying within Great Britain About their time away inside Great BritainAbout their time away outside Great BritainThis field is hidden when viewing the formSection BreakWhy are they going to be away from home?(Required)For example on holiday, visiting relatives, to receive medical treatmentCountry or region that they are going to(Required)When are they going?(Required)DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920When will they return home?(Required)DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Are they a member of the armed forces posted overseas, a mariner or a continental shelf worker?(Required)Please select…Member of the armed forces posted overseasMarinerContinental shelf workerNone of the above Other informationPlease use this box to tell us any other informationIf you have no further information to give us, leave the box blank
