Forms home Safe and Secure Form Step 1 of 22 4% Confirmation I acknowledge that no work should be carried out until I have written confirmation of grant approval. You may receive a maximum of £5,000 dependent on what we decide is reasonable cost for the work you need. You do not have to repay the grant. We do not need any information about your income or savings. If you do not have anyone to help you, the Home Improvement Team may be able to help. The cost of this service can be included in the grant you receive, you will not need to pay separately for this. If you want to arrange for a caseworker to visit and assist you, please contact us. Applicant’s detailsTitle(Required)MrMrsMissMsOtherIf other, please specify(Required)Firstname(Required)Surname(Required) Applicant’s detailsDate of Birth(Required) Day Month Year National Insurance Number(Required) Applicant’s detailsEmail address(Required) Telephone number(s)(Required) Are you a student?(Required)YesNoMarital Status(Required)SingleMarried/Partner/living togetherMarital status refers to the relationship you have with the partner you live with. For the purpose of this form, partner includes both same sex partners and partners of the opposite sex, whether married or living together. What is the property address where the grant works will be carried out?(Required)Find addressSelected address Do you own the above property?(Required)YesNoYou cannot apply for this grant Spouse/Partner detailsTitle(Required)MrMrsMissMsOtherIf other, please specify(Required)Firstname(Required)Surname(Required) Spouse/Partner detailsDate of Birth(Required) Day Month Year National Insurance Number(Required)Telephone number(s)(Required) Does anyone else shares ownership of this property?(Required)YesNo Shared ownership detailsTitle(Required)MrMrsMissMsOtherIf other, please specify(Required)Firstname(Required)Surname(Required) Do you want us to contact someone else on your behalf e.g. friend, family?(Required)YesNo Contact details of friends & family Firstname(Required)Surname(Required) Contact details of friends & family Telephone number(s)(Required) Choosing a ContractorPlease select your preferred method.(Required)I would like the Council to arrange to carry out the works on my behalf by sourcing a contractor. The Council operates a Dynamic Purchasing System (DPS) to support applicants and those in need of minor building works to meet their home environmental needs in engaging with reputable and compliant contractors. Independence Community Interest Company manage the DPS on behalf of the London Borough of Redbridge.I would like to source my own contractor to undertake the adaptation work. I understand that I will be required to submit 2 or 3 quotations for the adaptation(s) from an approved contractor to ensure that the grant awarded is fair value. I understand that I must provide an itemized quotation to demonstrate that I have met the schedule of works. I will also need to provide a valid invoice in order for the Council to pay the grant.It is important to note that as the work is being carried out on your home the contract for works will be between you and the contractor. This means the council is not responsible should you have and dispute with a contractor during or after the works are complete. Diversity MonitoringThe London Borough of Redbridge is committed to equality in all its activities and responsibilities. This means taking action to ensure that all Council services are accessible and that all users of Council services are treated fairly. The information you give on this form will remain strictly confidential, in accordance with the Data Protection Act 1998. Gender(Required)MaleFemaleIs your gender identity the same as at birthYesNo Age(Required)0-1718-2425-3435-4445-5455-6465+ Do you consider yourself to have a disability?(Required)YesNoPlease select the diability you have Hearing Reduced Mobility Mental Illness Speech Other disability If other disability, please specify(Required) Sexual orientation(Required)HeterosexualLesbianGayBi –sexualPrefer not to say Religion/Beliefs(Required)ChristianJewishMuslimSikhBuddhistHinduNoneAny other religion EthnicityWhite BritishWhite IrishWhite ScottishWhite WelshGypsyIrish TravellerAny other White backgroundWhite and CaribbeanWhite and AfricanWhite and AsianAny other mixed backgroundIndianPakistaniBangladeshiAny other Asian backgroundBlack/Black BritishBlack CaribbeanBlack AfricanAny other black backgroundChineseAny other ethnic groupIf other Ethinic group, please specify(Required) What will we do with information you provide?The Home Improvement Team of the London Borough of Redbridge will be collecting this information to process your application for a grant. Some of the data we collect will be personal data about you. This will include amongst other things: name, residential address and date of birth. We will also collect details of household income, benefits and all those living at your address. We review our retention periods of the information we hold about you on a regular basis. We are legally required to hold some types of information to fulfil our statutory obligations. We will hold your personal information on our systems for as long as it is necessary for the service that we provide to you, or as required by law. The information you provide may be shared with other enforcement agencies and local authorities nationally where breaches of statutory legislation are suspected. We may also be obligated to share your personal details with other organisations for crime and taxation purposes including for the prevention or detection of crime, the capture or prosecution of offenders; and the assessment or collection of tax or duty under section 29 of the Data Protection Act. We will not use your information for marketing. Further information on how we process your data and your rights can be found in our privacy policy online at www.redbridge.gov.uk Declaration(Required) By selecting, I declare that to the best of my knowledge, the information I have provided is correct. WARNING: If you knowingly make a false statement, you may be liable to prosecution.
