Housing Application Change of Circumstances Form

Latest revision date: August 2020
Revision due date: August 2021


Only complete this form if you are already on the Housing Register


Who should use this form

People who are already on the Housing Register or who have registered a Housing Application and whose circumstances have changed.
For example:

  • you have changed address

  • a baby has been born

  • your landlord has given you a notice to end your tenancy


What happens next

When we receive your completed form we will update your application. We aim to do this within 10 working days of receiving your form. Where the change in your circumstances affects the priority of your application we will contact you and let you know your new priority.

Protecting your personal data

By completing this form you acknowledge that we will follow our responsibilities under data protection legislation. We will store the information securely, share it with partners and other statutory agencies where we have the right under law to do this, use it only for the purpose it was provided and process it as set out in our privacy policy. For more information please see our privacy policy on our website

Please note this form only gives you one hour to complete, if you need more time simply click on the ‘SAVE FORM’ button at the end of this form.

  • Application Information
  • The details you provide in this section help us match this form to your application and so you should tell us here the details from your original application– for example
    • If you’re changing your name tell us here the name we have recorded for your application not your new name.
    • If you’re changing your address please tell us the address you have just moved from and not your new address.

    You will get a chance in section 2 to tell us about the changes to your application.
  • Housing application number *

    BERN

  • Title *

  • First Name *

  • Last Name *

  • Please tell us the address we have recorded for your application *

  • Date of Birth *

  • National Insurance Number *

  • Phone Number

  • Mobile Number

  • Email Address

  • Change of Circumstances
  • In this section we will ask you what part of your application you want to update. You must answer all of the questions before you will be able to submit your form.
  • Changing your address
  • Do you want to tell us about a change of address?

  • Please tell us your new address *

  • When did you move into this address *

  • What type of property is your new home? *

  • Please give details

  • At your current address are you one of the following *

  • Landlords Name

  • Landlords Name

  • Landlords Name

  • Landlords Address

  • Landlords Address

  • Landlords Address

  • Landlords Phone Number

  • Landlords Phone Number

  • Landlords Phone Number

  • How many bedrooms are there in the property? *

  • Landlords name (please note we will contact your landlord for a reference). *

  • Landlords address (please note we will contact your landlord for a reference). *

  • Landlords phone number *

  • Does anyone else live at your new address (this includes any people moving with you and those not moving with you) *

  • Additional occupants

  • Adding or removing people from your application
  • Is there an existing joint applicant? *

  • Joint applicant - someone applying with you
  • Title *

  • First Name *

  • Last Name *

  • Date of Birth *

  • National Insurance Number *

  • Do you want to add a joint applicant to your application *

  • Add joint applicant
  • Tell us about the person you want to add as a joint applicant
  • Title *

  • First Name *

  • Last Name *

  • Date of birth *

  • Address *

  • National Insurance number *

  • What is their gender?

  • How would they describe their ethnic origin

  • What is their first language

  • If other, please give details

  • What is their faith

  • If other, please give details

  • Do they consider themselves disabled

  • If yes, please tick all that apply

  • If we get in touch with you, do you need any of the following?

  • Language required:

  • If we visit you, should we do any of the following?

  • If we have to make a special appointment to visit you, should we:
  • Make the appointment with a key worker (for example, social worker)?

  • Name and Contact details:

  • Make the appointment with someone who has the power of attorney for you?

  • Name and Contact details:

  • How would you describe your sexuality?

  • Do they live with you? *

  • When did they start living with you? *

  • Where did they live before? *

  • Where do they live?

  • When did they move in here?

  • And are they?

  • Have they lived anywhere else in the last five years?

  • Where else have they lived in the last five years?

  • Criminal or Anti Social Behaviour
  • We can refuse to give you access to the housing register if you or a member of your household have been involved in criminal or antisocial behaviour. If you want us to consider the joint applicant, you must say whether they have been involved in or convicted of any of the following activities:
  • Does your joint applicant have any of the following criminal convictions (tick all that apply)

  • If yes to any of the above, please list convictions

  • Convictions

  • If yes, what are their contact details?

  • Do you want to add anyone else to your application?

  • If you are currently pregnant then you will need to let us know the full name and date of birth once the baby arrives. You can tell us by completing our online Homeseeker contact form or you can write to us at Berneslai Homes Assessment Team, PO Box 627, Barnsley, S20 9FZ.
  • Extra people

  • Do you want to remove someone from your application

  • Remove people
  • To remove

  • Changing the type and location of properties you want
  • Do you want to change the property type you want to be rehoused in

  • What type of property do you want

  • How many bedrooms do you need?

  • Please note that we only have a limited number of 5 bedroom properties
  • Do you want to change the areas you want to be rehoused in?

  • Change the areas I am interested in being rehoused in

    Please tick all the areas below that you are interested in

  • Changing your name
  • Do you want to change your name?

  • New Name
  • Title *

  • First Name *

  • Surname *

  • Previous Name
  • Title *

  • First Name *

  • Last Name *

  • Reason for change *

  • If other, please give details

  • Other Changes
  • Have you been served a Notice to Quit?

    A Notice to Quit is a letter from your landlord telling you that your tenancy is going to end and you will need to contact the Housing Options, Advice and Homeless Prevention Service on (01226) 773870 who will provide further advice and assistance.

  • If yes what date do you have to leave?

  • Are there any other changes to your application

  • Please tell us about any other change in circumstances

  • Upload Documents
  • Use this section to upload information that may help us deal with your change of circumstances. For example a landlord reference, a birth certificate or a proof of pregnancy.

    To upload this information you can either use a scanner or take a photo with your phone or tablet. Just click the upload button.

    More than one piece of information? Just click the “Add” button after you’ve finished uploading each one. You can upload a maximum of five pieces of evidence.


    If you haven’t got the evidence to upload at this point you can save your form until you have or you can upload it later using our “Document upload e form” which you can find on the Tell Us About it section of our website.
  • Documents of proof

    You can upload the following file types: JPG, PDF, PNG
    Please note if you are going to save this form instead of submitting, you will need to upload your file when you submit.

  • Confirmation
  • By ticking the box below, I declare that I fully understand and agree with the following statements:

    - I declare that the information I have given on this form is correct and complete. 

    - I understand that if you later find that I have deliberately supplied false information or omitted to supply information, this can affect my rights to a tenancy and you may take action against me if I am granted a tenancy.

    - I understand that if I have not completed this form fully it may result in a delay in us acting on your request.

    - I understand you may share my information with other agencies to detect and prevent fraud.

    - I confirm and understand that if I are in rented accommodation that you will contact my landlord for a reference.