Apply for a Council Tax disabled reduction 1Using the form2Declaration3About you4About the disabled person5Reason for application6Other information If you have adapted your home to meet the needs of a disabled person who does not need to be an adult to qualify but must permanently live in the property and the disabled person must be permanently and substantially disabled by illness, injury or congenital deformity or other reason, we may be able to reduce your Council Tax bill. Find out more about a disabled reduction This form will ask you to provide your details the name and address of the disabled person the nature of their disability which of the features listed above the property has the date from which these conditions apply. 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 information that I will give on this form will be correct and true I will notify you of any relevant changes that could result in an amendment to this discount within 21 days of the change 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)Please provide a mobile number if you have one as we are now using text messaging (SMS) to contact some of our residents.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 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 Council Tax bills by email rather than post. We will send all future Council Tax bills to the email address you have given above. This service is only available to people who are named on the bill. 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 the disabled personCouncil Tax account reference (if known)Please select the option which best applies(Required) I am the disabled person applying for a discount and I am responsible for the Council tax bill I live with the disabled person applying for a discount and I am responsible for the Council tax bill Full name of the disabled person(Required)What is your relationship to this person?(Required)Is this person 18 years or over?(Required) Yes No Address for which you are applying (where the disabled person lives)Address(Required) Address line 1 Address line 2 Town or city Postcode Reason for applicationWhat is the nature of the disabled person's disability?(Required)Please select all of the options that apply to the property(Required) There is an extra bathroom (not a second toilet) or kitchen needed by the disabled person There is a room other than a bathroom, kitchen or toilet which the disabled person needs and uses The disabled person uses a wheelchair indoors None of the above Please provide details about how this meets the needs of the disabled person(Required)Please confirm what the additional room is(Required)How does this meet the needs of the disabled person?(Required)For example, storage or use of special equipment. if the additional room is not being used for its original purpose, please provide additional detailsWhen do these conditions apply from?(Required)DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920About backdating the applicationIf the conditions have been in place for more than 12 months and you would like to request the reduction is backdated, we require a letter from a professional medical practitioner stating the date the conditions have been in place for, the relevant circumstances and the date when the adaptations were made, if known. Without this additional evidence, the reduction cannot be backdated. The letter can be uploaded to this form or sent to the local authority by post. Upload professional medical practitioner letter to support your application 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: 20 MB, Max. files: 5. You do not qualify for this reductionBased on your answers, you do not qualify for this reduction. If you think you need to change any of your answers, use the ‘Previous’ button. Otherwise, please end your application. Should your circumstances change in the future, you may complete the form again. Other informationPlease use this box to tell us any other information.If you have no further information to give, leave this box blank