Forms home Household Support Fund Step 1 of 33 3% This form is an application for awards from the Household Support Fund (HSF) covering the period from 1 October 2024 to 30 March 2025. The HSF is funded by Government and provides one-off awards to support vulnerable households with essential costs, such as energy, food, and water. Only one application is permitted per household at any given time (*a household includes all adults and children that live in the same property). The HSF is discretionary, and each application will be strictly assessed against the Council’s eligibility criteria detailed in the next section. The HSF if strictly limited and will not be available beyond 30 September 2024. The Council reserves the right to close this scheme earlier than this date once all funds are used. If you require information or advice regarding benefits, debt advice, employment opportunities, or housing matters, we strongly encourage you to visit www. costofliving.redbridge.gov.uk (opens in new window) and www.gov.uk/cost-of-living for further guidance (opens in new window). Information / evidence required Please be prepared with the information and evidence listed below which will assist you in completing this application. We are unable to process any applications or make any awards without this information and evidence. Information: Income from all adults residing in the household Debts Evidence: Proof of ID One of : - Passport Driver’s Licence National Identity Card Home Office Biometric Card/Letter Proof of Address One of : - Council Tax Bill Gas Electricity Water Proof of income Bank Statement(s) demonstrating all income sources in the household. Payslips for anyone in the household who is working. If self-employed a copy of the latest accounts. Utility Bills Where applicable, please provide utility bills for gas, electricity and water for the last 3 months. Save and Continue Please click on the save and continue button located at the bottom of each page to complete this application at a later time. Eligibility criteriaHas the applicant or any member of their household received a Household Support Fund payment in the last year?(Required) Yes No Is the applicant or any member of their household: (please select all that apply)(Required) Disabled Victim of domestic abuse An asylum seeker Has no recourse to public funds Not applicable Is the applicant over 18?(Required) Yes No Does the applicant reside in Redbridge?(Required) Yes No Has the applicant been placed in out of borough, temporary accommodation provided by Redbridge Council?(Required) Yes No Not Applicable We are sorry but we cannot proceed with this application at this stage. Eligibility criteriaIs the applicant in financial crisis? This can be defined as ‘an inability to meet essential payments out of disposable income or at all’. Examples include non-payments of essential bills or having to borrow further to repay existing debts.’(Required) Yes No Does the applicant, and their household have savings of more than £1000?(Required) Yes No We are sorry but we cannot proceed with this application at this stage. Eligibility criteriaDeclaration(Required) I confirm that all statements provided are true and accurate to the best of my knowledge and belief. Referrer or ResidentIs this form being filled in on behalf of a resident by a professional or are you completing this independently, on your own as a resident?(Required) I am a professional I am a resident About you the referrerFirst name(Required) Last name(Required) Your email address(Required) About you the referrerYour Organisation e.g. Redbridge Council(Required) Service Area & Department (if applicable) e.g. Housing – Rent Recovery Service Your role(Required) About the applicantApplicant's first name(Required) Applicant's last name(Required) Applicant's address(Required) Street Address Address Line 2 Town AberdeenshireAngus/ForfarshireArgyllshireAyrshireBanffshireBedfordshireBerkshireBerwickshireBlaenau GwentBridgendBuckinghamshireButeshireCaerphillyCaithnessCambridgeshireCardiffCarmarthenshireCeredigionCheshireClackmannanshireConwyCornwallCromartyshireCumberlandDenbighshireDerbyshireDevonDorsetDumfriesshireDunbartonshire/DumbartonshireDurhamEast Lothian/HaddingtonshireEssexFifeFlintshireGloucestershireGwyneddHampshireHerefordshireHertfordshireHuntingdonshireInverness-shireIsle of AngleseyKentKincardineshireKinross-shireKirkcudbrightshireLanarkshireLancashireLeicestershireLincolnshireLondonMerthyr TydfilMiddlesexMidlothian/EdinburghshireMonmouthshireMorayshireNairnshireNeath Port TalbotNewportNorfolkNorthamptonshireNorthumberlandNottinghamshireOrkneyOxfordshirePeeblesshirePembrokeshirePerthshirePowysRenfrewshireRhondda Cynon TaffRoss-shireRoxburghshireRutlandSelkirkshireShetlandShropshireSomersetStaffordshireStirlingshireSuffolkSurreySussexSutherlandSwanseaTorfaenVale of GlamorganWarwickshireWest Lothian/LinlithgowshireWestmorlandWigtownshireWiltshireWorcestershireWrexhamYorkshire County Post code About the applicantApplicant's phone number(Required) Applicant's email address(Required) About the applicantApplicant's date of birth(Required) Day Month Year Applicant's National Insurance number Applicant’s Council Tax reference number Professional support We would like to know if the applicant is receiving any professional support from the departments/organisations listed below or from any other sources. This will enable us to identify any other relevant support that is needed.Is the applicant being supported by any of these professional services? Select all that apply Health & Adult Social Services First Contact Team Children's Social Care Education / Education Welfare Service Housing Domestic Abuse Service Work Redbridge National Health Service Adult Mental Health Hospital Social Work Team NELFT Children Centres School Nursing Health Visiting Other Not applicable What other professional service is supporting the applicant?(Required) Is the applicant being supported with their needs by other family members, specialists or support organisations?(Required) Yes No Not applicable Please provide details of the support the applicant is receiving.(Required)For example, this could include support from Social Services, Citizens Advice or any other professional service. Benefits check Benefits support people on low incomes and those with specific needs. This can range from benefits for people who need regular care because of disabilities to unemployment benefits. We strongly encourage all applicants and adults residing in the same property to consider doing a welfare benefits check. This check is a vital step towards securing the financial help they may be entitled to but may not be aware of. This is particularly important as the Household Support Fund is expected to come to an end by 30 September 2024. Benefit calculators: You can use the following user friendly benefit calculators to check what benefits you can get: Turn2us benefits calculator (opens in a new window) Entitledto benefits calculator (opens in a new window) Policy in Practice benefits calculator (opens in a new window) You’ll need information about savings, income, pension, childcare payments and any existing benefits (for you and your partner if applicable). For information on how to use calculators visit the Citizens Advice website (opens in new window) Welfare Benefits Team You can also contact the Welfare Benefits Team for further assistance by emailing welfare.benefits@redbridge.gov.uk or by phone on 020 8708 4180 (Monday to Thursday 9am to 12:30pm only). A professional has completed a benefits check for the applicant Yes No The applicant has completed a benefits check Yes No Confirmation of benefits check The applicant confirms that they will contact the organisations above for a benefits check. EmploymentWhat best describes the applicant's current employment situation?(Required)Please selectEmployed full timeEmployed part timeSelf employedUnemployedStudentRetiredFull time carerPensionerOtherPlease specify other employment situation Work Redbridge To assist households in achieving financial resilience and stability it is a condition of the Household Support Fund for working age residents to engage with Work Redbridge. Work Redbridge have Employment Officers who work with people with specific needs including: Mental Health / Substance Abuse / Criminal Records Care Leavers Children’s Services / Homes for Ukraine /Adult services / Special Education needs Housing Work Redbridge offer the following services: Benefit checks to confirm a client’s entitlements. Offer in house appointments with a Disability Employment Advisor from Redbridge Jobcentre Plus for vulnerable households claiming disability benefits. Arrange English language (ESOL) and digital literacy courses. CV writing / building Referrals to Citizens Advice Redbridge for assistance with social welfare enquiries 12 months in work support, including additional training if required and benefits advice if there is a change in wages. Help with interview techniques (virtual / telephone / in person The applicant can engage with Work Redbridge even if they are already engaging with another employability service, for example, Maximus. Work Redbridge can provide information and advice to residents who may have certain barriers of getting into work, including: childcare issues debt, including rent arrears. housing needs language barriers health - physical / mental health issues long term unemployment literacy, low digital skills, and access to IT immigration status The applicant agrees to engage with Work Redbridge and consents to us providing their details to Work Redbridge as a condition of receiving an HSF payment.*This will only apply to working age applicants; each application will be assessed individually. Yes No Already Engaging Outside of working age Household detailsWhat is the composition of your household? This includes and adults and children that reside with the applicant. (please tick all that apply)(Required) Single Couple Children Non dependants (other adults living with you) Pensioner(s) Please provide details of individuals who are part of your Household Name Date of birth Relationship to the applicant Actions Edit Delete There are no Household members. Add Household member Maximum number of household members reached. Is the applicant, or any member of their household sick, disabled or vulnerable in any way?(Required) Yes No Not applicable Please provide further details(Required) Income Provide income details for all adults in the householdHousehold income sources Income source Amount Frequency Actions Edit Delete There are no Income sources. Add Income source Maximum number of income sources reached. Debts The applicant can get free independent help and advice from any of the following advice agencies: Money Adviser Network – for personalised, specialist debt advice National Debtline – call 0808 808 4000, Monday to Friday, 9am to 9pm and Saturday, 9:30am to 1pm StepChange Debt Charity – call 0800 138 1111, Monday to Friday, 8am to 8pm and Saturday, 8am to 4pm Payplan– money and debt advice, 0800 280 2816 Mary Ward Legal Centre – provides free independent advice to people who live and work in London to help them access their legal rights and entitlements; the main areas of law they help with are debt, housing and welfare benefits Debt Free London - get 24/7 confidential support and advice around debt, saving and budgeting. Whether you need advice on rent arrears, council tax, utility bills, credit cards or loan debt, advisors will be on hand night or day. Citizens Advice Redbridge - email advice@citizensadviceredbridge.org.uk Does the resident have any debts? Yes No Debts Type of debt Total amount due Monthly repayments Actions Edit Delete There are no Debt. Add Debt Maximum number of debt reached. I agree to be referred to the Money Advisers Network if Redbridge Council believes I would benefit from free specialist debt advice.The Money Advisers Network is wholly independent of the Council and will deal with you confidentially. Yes No Employment IncomeDo you or anyone in your household receive income from employment?(Required) Yes No AccommodationWhat type of accommodation does the applicant occupy?(Required)Please selectPrivate rentedCouncilHousing AssociationSheltered / SupportedHomeowner / MortgageeLiving with familiy/friendsTemporary accommodationHomelessOtherPlease specify other accommodation(Required)For rented accommodation, was this furnished or unfurnished when the tenancy commenced?(Required) Furnished Part furnished Unfurnished Not applicable We may need to contact the applicant's landlord to verify some information, please provide their name and contact details. AccommodationDo any of the following issues affect the applicant? (tick all that apply) Affordability – rent increases Affordability – mortgage increases Court Action – Repossession Court Action – Eviction Disrepair Damp & Mould Benefits – problems with Housing Benefit Benefits – problems with Universal Credit (Housing Element) Benefits – delays / payment stopped Overcrowding Unsuitable living conditions Problems in applying for social housing Landlord Harassment Other (text box) Not Applicable Please provide us with further information Financial support We will require all applicants to provide evidence for certain categories of support being requested, including gas, electricity, water, transport costs and phone/broadband costs. Documents can be uploaded in the next section. The Household Support Fund is discretionary and there is no guarantee that all financial support that is being requested will be awarded. Any awards made are a contribution towards the household expenses. Awards will be determined by the Household Support Fund Team based on the household’s personal, household and financial circumstances. We encourage residents to register at the Ilford Community Grocery Store. Annual registration is £5. Each shop costs £5 and provides residents with 12 items of food and household essentials worth over £20. Visit Community Grocery Ilford (opens in new window) for further information. What financial assistance does the applicant require? (tick all that apply)(Required) Food Gas Electricity Water Clothing Other essentials Financial supportProvide as much information as possible regarding the reason for requesting the financial support including any financial difficulties or general difficulties being faced.(Required)We use eVouchers to provide awards to successful applicants. The vouchers can be delivered by email, text or by post. Please confirm the preferred option below.(Required) Email Text Post Email address(Required) Mobile number(Required) Address(Required) Evidence Upload The documents listed below need to be uploaded in order to finalise this application. Proof of ID Please upload a copy of one of the following documents: Passport Driver’s Licence National Identity Card Home Office Biometric Card/Letter Please upload a clear image of the evidence being requested.(Required)Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 10 MB. Evidence Upload The documents listed below need to be uploaded in order to finalise this application. Proof of Address Please upload a copy of one of the following documents: Council Tax Bill Gas Electricity WaterPlease upload proof of address(Required)Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 10 MB. Evidence Upload Bank Statement(s)(Required)Please upload bank statements demonstrating all income sources provided in section 11 (Income). Drop files here or Select files Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 10 MB. Utility Bills(Required)Where applicable, please provide utility bills for gas, electricity and water for the last 3 months. Drop files here or Select files Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 10 MB. Proof of Earnings(Required)Please upload the latest two wage slips or if you are self-employed your latest set of accounts. Drop files here or Select files Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 10 MB. EvidenceConfirmation of evidence I confirm that I, the professional have reviewed all evidence needed to support this application I have viewed the applicant and their household’s: Proof of ID Proof of Address Bank statements Utility bills Confirmation of savings I can confirm that neither the applicant or their household have more than £1000 in savings Equality monitoring To help us make sure our policies meet the needs of all our communities, we ask that you complete the questions below. This is entirely optional and will be used for monitoring purposes only.Do you want to answer the equality questions?(Required) Yes, answer the equality questions No, skip the equality questions Equality monitoringWhat is your sex? Female Male Prefer not to say Is the gender you identify with the same as your sex registered at birth? Yes No Prefer not to say Equality monitoringWhat is your age?Please selectUnder 1818-2425-3435-4445-5455-6465 or aboveWhat is your sexual orientation? Heterosexual or straight Gay or lesbian Bisexual Other Prefer not to say Equality monitoringWhat is your ethnic group? White Mixed or multiple ethnic groups Asian or Asian British Black, African, Caribbean or Black British Other ethnic group Prefer not to say Which of the following best describes your White background? English, Welsh, Scottish, Northern Irish or British Irish Gypsy or Irish Traveller Any other White background Prefer not to say Which of the following best describes your mixed or multiple ethnic groups background? White and Black Caribbean White and Black African White and Asian Any other mixed or multiple ethnic background Prefer not to say Which of the following best describes your Asian or Asian British background? Indian Pakistani Bangladeshi Chinese Any other Asian background Prefer not to say Which of the following best describes your Black, African, Caribbean or Black British background? African Caribbean Any other Black, African or Caribbean background Prefer not to say Which of the following best describes your background? Arab Any other ethnic group Prefer not to say Equality monitoringWhat is your religion?Please selectNo religionChristian Including Church of England, Catholic, Protestant and all other Christian denominations.BuddhistHinduJewishMuslimSikhAny other religionPrefer not to say Equality monitoringDo you have any physical or mental health conditions or illness lasting or expected to last 12 months or more? Yes No Prefer not to say Do any of your conditions or illnesses reduce your ability to carry out day to day activities?For example eating, washing, walking or going shopping. Yes, a lot Yes, a little Not at all Prefer not to say Please tell us your postcode to help us compare the views of residents from different areas of the Borough. Declaration This application and all documents related to this application will be treated in line with the GDPR Act 2018 and may be shared within the authority and with other authorities. Any data deemed to be 'sensitive personal data' under the GDPR Act 2018 will only be disclosed to third parties as necessary for the operation and administration of the scheme and to other organisations where necessary to establish entitlement or otherwise as required by law. This authority may make enquiries about the information needed to support the application and to prevent fraud. If you receive Household Support Fund payments by providing incorrect details or not giving us full details or providing false information you could be prosecuted. Please read all the points carefully and make sure you understand them before submitting this form. I declare that the information I have given on this form is correct and complete. I understand that if I knowingly give information that is incorrect or incomplete, I may be liable to prosecution or other action. I understand that I must promptly tell the authority of any further information which may affect the outcome of my application which I become aware of after it has been made. I understand that I must tell the authority straightaway if I have a change of circumstances which may affect my application. I understand that I must provide any supporting evidence requested from me within one month of the date that I submit this claim, otherwise my claim may not be fully determined. Confirmation I confirm I have read and understood all points and all information provided is correct and complete
