{"id":361,"date":"2026-01-27T12:44:21","date_gmt":"2026-01-27T12:44:21","guid":{"rendered":"https:\/\/partnershipone.com\/DDC\/?page_id=361"},"modified":"2026-06-19T14:56:11","modified_gmt":"2026-06-19T13:56:11","slug":"ct-disabled-discount","status":"publish","type":"page","link":"https:\/\/partnershipone.com\/DDC\/ct-disabled-discount\/","title":{"rendered":"Apply for a Council Tax disabled reduction"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_29' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_29'  action='\/DDC\/wp-json\/wp\/v2\/pages\/361#gf_29' data-formid='29' novalidate><div id='gf_page_steps_29' class='gf_page_steps'><div id='gf_step_29_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'>Using the form<\/span><\/div><div id='gf_step_29_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'>Declaration<\/span><\/div><div id='gf_step_29_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'>About you<\/span><\/div><div id='gf_step_29_4' class='gf_step gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'>About the disabled person<\/span><\/div><div id='gf_step_29_5' class='gf_step gf_step_pending'><span class='gf_step_number'>5<\/span><span class='gf_step_label'>Reason for application<\/span><\/div><div id='gf_step_29_6' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>6<\/span><span class='gf_step_label'>Other information<\/span><\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_29_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_29' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_29_24\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>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.<\/p>\n\n<p><a href=\"https:\/\/www.dover.gov.uk\/council-tax\/discounts-and-exemptions\/disability-relief\"target=\"_blank\">Find out more about a disabled reduction<\/a><\/p>\n<h2>This form will ask you to provide<\/h2>\n<ul>\n  <li>your details<\/li>\n  <li>the name and address of the disabled person<\/li>\n  <li>the nature of their disability<\/li>\n  <li>which of the features listed above the property has<\/li>\n  <li>the date from which these conditions apply.<\/li>  \n<\/ul>\n<p><\/p>\n<p>Please have this information ready as pages time-out after one hour.<\/p>\n\n<p>Do not use your browser back button &#8211; if you need to go to a previous page click on the previous button at the bottom of each page.<\/p>\n\n<h2>Privacy Statement<\/h2>\nDover 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 <a href=\"https:\/\/www.dover.gov.uk\/Website\/Privacy-and-Cookies.aspx\"target=\"_blank\">Privacy page<\/a>.<\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_29_26' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Begin form<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_29_2' class='gform_page' data-js='page-field-id-26' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_29_2' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_29_82\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Declaration<\/h3><div class='gsection_description' id='gfield_description_29_82'><p>Please check the box below to confirm that you have read, understand and agree to the following statements before completing this form:<\/p>\n\n<ul>\n  <li>I confirm the information that I will give on this form will be correct and true<\/li>\n  <li>I will notify you of any relevant changes that could result in an amendment to this discount within 21 days of the change<\/li>\n  <li>I understand that if I give information that is false this could lead to a penalty or legal proceedings being taken against me<\/li>\n  <li>I understand my data may be shared with other departments as permitted by law<\/li>\n<\/ul><\/div><\/div><fieldset id=\"field_29_6\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Declaration<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_6.1' id='input_29_6_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_29_6_1' ><span class='gform-field-label__text'>I understand and accept the above declaration<\/span><\/label><input type='hidden' name='input_6.2' value='I understand and accept the above declaration' class='gform_hidden' \/><input type='hidden' name='input_6.3' value='19' class='gform_hidden' \/><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_29_8' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_29_8' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_29_3' class='gform_page' data-js='page-field-id-8' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_29_3' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_29_55\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About you<\/h3><\/div><div id=\"field_29_44\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_44'><span class='gform-field-label__text'>Title (for example Mr, Mrs, Ms, Miss)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_44' id='input_29_44' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_45\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_45'><span class='gform-field-label__text'>First name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_29_45' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_46\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_46'><span class='gform-field-label__text'>Last name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_29_46' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_51'><span class='gform-field-label__text'>Contact phone number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_29_51'>Please provide a mobile number if you have one as we are now using text messaging (SMS) to contact some of our residents.<\/div><div class='ginput_container ginput_container_text'><input name='input_51' id='input_29_51' type='text' value='' class='large'  aria-describedby=\"gfield_description_29_51\"  placeholder='99999 999999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99999 999999\"\/><\/div><\/div><fieldset id=\"field_29_11\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Email address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_29_11'>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.<\/div><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_29_11_container'>\n                                <span id='input_29_11_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_29_11' class='gform-field-label gform-field-label--type-sub '>Enter email address<\/label>\n                                    <input class='' type='email' name='input_11' id='input_29_11' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_29_11\" \/>\n                                <\/span>\n                                <span id='input_29_11_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_29_11_2' class='gform-field-label gform-field-label--type-sub '>Confirm email address<\/label>\n                                    <input class='' type='email' name='input_11_2' id='input_29_11_2' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_29_11\" \/>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_29_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Would you like to receive your Council Tax bills by email?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_29_13'>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<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_29_13'>\n\t\t\t<div class='gchoice gchoice_29_13_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='Yes'  id='choice_29_13_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_29_13\"   \/>\n\t\t\t\t\t<label for='choice_29_13_0' id='label_29_13_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_13_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='No'  id='choice_29_13_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_13_1' id='label_29_13_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_29_16' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_29_16' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_29_4' class='gform_page' data-js='page-field-id-16' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_29_4' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_29_49\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the disabled person<\/h3><\/div><div id=\"field_29_28\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_28'><span class='gform-field-label__text'>Council Tax account reference (if known)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_29_28' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_29_71\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Please select the option which best applies<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_29_71'>\n\t\t\t<div class='gchoice gchoice_29_71_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='I am the disabled person applying for a discount and I am responsible for the Council tax bill'  id='choice_29_71_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_71_0' id='label_29_71_0' class='gform-field-label gform-field-label--type-inline'>I am the disabled person applying for a discount and I am responsible for the Council tax bill<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_71_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='I live with the disabled person applying for a discount and I am responsible for the Council tax bill'  id='choice_29_71_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_71_1' id='label_29_71_1' class='gform-field-label gform-field-label--type-inline'>I live with the disabled person applying for a discount and I am responsible for the Council tax bill<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_29_57\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_57'><span class='gform-field-label__text'>Full name of the disabled person<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_29_57' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_73\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_73'><span class='gform-field-label__text'>What is your relationship to this person?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_73' id='input_29_73' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_29_75\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is this person 18 years or over?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_29_75'>\n\t\t\t<div class='gchoice gchoice_29_75_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='Yes'  id='choice_29_75_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_75_0' id='label_29_75_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_75_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='No'  id='choice_29_75_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_75_1' id='label_29_75_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_29_54\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Address for which you are applying (where the disabled person lives)<\/h3><\/div><fieldset id=\"field_29_69\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full custom-address-field d-block gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_zip ginput_container_address gform-grid-row' id='input_29_69' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_29_69_1_container' >\n                                        <label for='input_29_69_1' id='input_29_69_1_label' class='gform-field-label gform-field-label--type-sub '>Address line 1<\/label>\n                                        <input type='text' name='input_69.1' id='input_29_69_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_29_69_2_container' >\n                                        <label for='input_29_69_2' id='input_29_69_2_label' class='gform-field-label gform-field-label--type-sub '>Address line 2<\/label>\n                                        <input type='text' name='input_69.2' id='input_29_69_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_29_69_3_container' >\n                                    <label for='input_29_69_3' id='input_29_69_3_label' class='gform-field-label gform-field-label--type-sub '>Town or city<\/label>\n                                    <input type='text' name='input_69.3' id='input_29_69_3' value=''    aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_69.4' id='input_29_69_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_29_69_5_container' >\n                                    <label for='input_29_69_5' id='input_29_69_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                    <input type='text' name='input_69.5' id='input_29_69_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_69.6' id='input_29_69_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_29_59' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_29_59' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_29_5' class='gform_page' data-js='page-field-id-59' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_29_5' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_29_60\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Reason for application<\/h3><\/div><div id=\"field_29_61\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_61'><span class='gform-field-label__text'>What is the nature of the disabled person&#039;s disability?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_61' id='input_29_61' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_29_62\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Please select all of the options that apply to the property<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_29_62'><div class='gchoice gchoice_29_62_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.1' type='checkbox'  value='There is an extra bathroom (not a second toilet) or kitchen needed by the disabled person'  id='choice_29_62_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_62_1' id='label_29_62_1' class='gform-field-label gform-field-label--type-inline'>There is an extra bathroom (not a second toilet) or kitchen needed by the disabled person<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_62_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.2' type='checkbox'  value='There is a room other than a bathroom, kitchen or toilet which the disabled person needs and uses'  id='choice_29_62_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_62_2' id='label_29_62_2' class='gform-field-label gform-field-label--type-inline'>There is a room other than a bathroom, kitchen or toilet which the disabled person needs and uses<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_62_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.3' type='checkbox'  value='The disabled person uses a wheelchair indoors'  id='choice_29_62_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_62_3' id='label_29_62_3' class='gform-field-label gform-field-label--type-inline'>The disabled person uses a wheelchair indoors<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_62_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.4' type='checkbox'  value='None of the above'  id='choice_29_62_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_62_4' id='label_29_62_4' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_29_76\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_76'><span class='gform-field-label__text'>Please provide details about how this meets the needs of the disabled person<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_76' id='input_29_76' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_29_77\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_77'><span class='gform-field-label__text'>Please confirm what the additional room is<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_77' id='input_29_77' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_29_78\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_78'><span class='gform-field-label__text'>How does this meet the needs of the disabled person?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_29_78'>For example, storage or use of special equipment. if the additional room is not being used for its original purpose, please provide additional details<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_78' id='input_29_78' class='textarea medium'  aria-describedby=\"gfield_description_29_78\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_29_63\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>When do these conditions apply from?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_29_63' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_29_63_2_container'><label for='input_29_63_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_63[]' id='input_29_63_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_29_63_1_container'><label for='input_29_63_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_63[]' id='input_29_63_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_29_63_3_container'><label for='input_29_63_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_63[]' id='input_29_63_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_29_81\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About backdating the application<\/h3><div class='gsection_description' id='gfield_description_29_81'>If 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. <\/div><\/div><div id=\"field_29_80\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_29_80'><span class='gform-field-label__text'>Upload professional medical practitioner letter to support your application<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_29_80' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_29_80&quot;,&quot;container&quot;:&quot;gform_multifile_upload_29_80&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_29_80&quot;,&quot;filelist&quot;:&quot;gform_preview_29_80&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/DDC\\\/?gf_page=cd67508b2a8ca4d&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/DDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/DDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;txt,pdf,doc,docx,rtf,jpg,jpeg,tif,tiff,bmp,png,xls,xlsx&quot;}],&quot;max_file_size&quot;:&quot;20971520b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:29,&quot;field_id&quot;:80,&quot;_gform_file_upload_nonce_29_80&quot;:&quot;272f33424e&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;5&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_29_80&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_29_80' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_29_80' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_29_80\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_29_80'>Accepted file types: txt, pdf, doc, docx, rtf, jpg, jpeg, tif, tiff, bmp, png, xls, xlsx, Max. file size: 20 MB, Max. files: 5.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_29_80'><\/ul> <div id='gform_preview_29_80' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_29_79\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">You do not qualify for this reduction<\/h3><div class='gsection_description' id='gfield_description_29_79'>Based on your answers, you do not qualify for this reduction. If you think you need to change any of your answers, use the \u2018Previous\u2019 button. \n<p><\/p>\n<p><\/p>\nOtherwise, please end your application. Should your circumstances change in the future, you may complete the form again.  <\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_29_64' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_29_64' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_29_6' class='gform_page' data-js='page-field-id-64' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_29_6' class='gform_fields top_label 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