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Notice: Household Flood Claim Form - Storm Bert & Storm Darragh: Were you affected???

Former occupant is in a residential home or long term patient in hospital

1. You will need your council tax reference number to proceed with this form.
Please provide your Council Tax Account Details
1. Please note you must be the account holder to apply for this exemption
2. Your Details
  1. First name*
  2. Last name*
3. Contact information
  1. Email address*
  2. Telephone number
4. Label
  1. Please provide your National Insurance number*
    Please use the correct format (e.g. AA112233b)
  2. Please provide your date of birth*
    
    Day
    
    Month
    
    Year
    
    D/M/YYYY
  We use this information as a reference when we do checks on the application
5. 3. Council Tax account
    
    Council Tax Reference