housing adaptation grant formdoc - kilkenny county council房适应授予表单文档-基尔肯尼郡议会

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1、KILKENNYCOUNTYCOUNCILHOUSINGADAPTATIONGRANTFORPEOPLEWITHADISABILITYAPPLICATIONFORMHGD1PLEASENOTE:NOESTIMATESAREREQUIREDATAPPLICATIONSTAGEPleasereadtheattachedconditionspriortocompletingthisform,inparticularthechecklistattherear.Incompleteformswillbereturnedandmaylea

2、dtodelaysinyourapplication.AllquestionsmustbeansweredPleasewriteyouranswersclearlyinblockcapitallettersWorksmustnotcommencepriortoreceiptbytheLocalAuthorityofthegrantapplicationandwrittengrantapprovalfromtheLocalAuthorityThepersonforwhomthegrantissoughtmustoccupythe

3、houseashis/hernormalplaceofresidencePLEASENOTE:LocalAuthorityTenantsdonotneedtosubmitallrequestedinformation.IfyouareaLocalAuthoritytenant,pleaserefertoChecklistonbackpageofform.AGTHEofrTheE:file-serverfs_tmpdownload99ce02d8e13e9ebd4701ceb133ed0e9f.docApplicant:

4、__________________________________________________________(HomeOwner)Address:_____________________________________________________________________________________________________________________________________________________________________________________________

5、_________________________________________________________________________________________________AreyouatenantofKilkennyCounty/BoroughCouncil:_____________________________Ifyes,howlong:___________________________________________________________TelephoneNo:__________

6、_______________MobileNo:__________________DateofBirth:_________________________P.P.S.No:___________________Occupation:__________________________________________________________Nameofpersonforwhomgrantaidissought(ifdifferentfromApplicant):____________________________

7、_________________________________________________Relationshiptoapplicant:______________________________________________________Nameoftheownerofthepropertytowhichtheproposedadaptationworksaretobecarriedout:_____________________________________________________________

8、________________GrossAnnualHouseholdIncome:€______________________________________________(Pleaserefertoexplanatorynote3below)Isthepersonw