Application for someone to act as an appointee - rehousing

Latest revision date: January 2022
Revision due date: January 2023


Who is this form for?



Please use this form if you want someone to act on your behalf for rehousing. You will need to ask them to provide two of the following documents as proof of their identify (one of the documents must have their address if it is a professional ie. Social worker, support worker etc. We would need a copy of their ID with name and job title on.):

A tenancy agreement
A passport
A UK driving license
A bank or building society book
A recent utility bill

You can either scan in this proof and email to homeseeker@berneslaihomes.co.uk or photocopy it and post to Berneslai Homes, PO Box 627, Barnsley, S70 9FZ. Please remember to tell us your name and address when sending documents in.

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
  • About you (the applicant)

  • First Name *

  • Last Name *

  • Application number

  • Address *

  • Phone Number *

  • Email Address

  • About the person you want to act on your behalf

  • First Name *

  • Last Name *

  • Address *

  • Phone number *

  • Relationship to you

  • Phone Number *

  • The reason you want them to act on your behalf

  • Agreement of the Applicant
  • By ticking the box below, I/we agree that the person named in this application can act on our behalf in relation to this tenancy. I understand that they will receive all information from Berneslai Homes about my tenancy. I/We understand that is my/our responsibility to tell you of any change in circumstances or if we want them to stop acting on my/our behalf, and understand that once I/We are rehoused this agreement comes to an end

  • Your name *

  • Confirm

  • Agreement of the person acting on behalf of the applicant
  • I agree to act on behalf of the applicant named in this application in matters relating to their housing application. I understand that I will receive all information from Berneslai Homes relating to their tenancy and I agree to share that information with the tenants. I agree to act in the interest of the applicants at all times. I agree to inform Berneslai Homes of any changes to my circumstances and I understand that is my responsibility to tell the tenant/s and Berneslai Homes if I want to stop acting on their behalf, and understand that once the applicant/s are rehoused this agreement comes to an end and my details will be removed.

  • Your name *

  • Confirm

  • Upload Documents
  • Use this section to upload two pieces of information from the following list (one of which must have the address of the appointee)::

    • A tenancy agreement
    • A passport
    • A UK driving licence
    • A bank or building society statement (you just need to show us your address and date of statement, please block out any bank details as we don’t need to see this)
    • A recent utility bill

    You will also need to upload a copy of your signature and that of the person to act on your behalf which you can both sign on a blank piece of paper below your printed name.

    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.

  • Document 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.