KERRY COUNTY COUNCIL AFFORDABLE HOUSING APPLICATION FORM / LOW COST SITE APPLICATION FORM

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1 KERRY COUNTY COUNCIL AFFORDABLE HOUSING APPLICATION FORM / LOW COST SITE APPLICATION FORM Please complete relevant details, ie. Affordable House or Low Cost Site Application. AFFORDABLE HOUSE: - LOCATION:- _ LOW COST SITE: - LOCATION:- _ Personal Details: NAME ADDRESS PHONE NO. (Daytime) PPS No: Date of Birth: ARE YOU: Married Separated/Divorced Single Single Parent Family Widow/Widower N.B: Married applicants must make a joint application. Separated or divorced applicants will be required to supply the appropriate legal documentation at a later date. 1. Are you a tenant of a local authority dwelling? Yes No Yes No 2. Are you a tenant purchaser of a local authority dwelling? Yes No Yes No

2 3. Have you been accepted on a local authority housing list? Yes No Yes No If Yes, Please state Local Authority & Reference Number 4. Are you a tenant for more than 1 year in accommodation Yes No Yes No provided by a Voluntary Housing Association? Please state name of Housing Association? Are you a first time Yes No Yes No No buyer? If no, please state any special circumstances that apply? (E.g divorce, separation etc.) Financial Details: GROSS INCOME (before tax) IN TAX YEAR ENDED 31 st December 2008 (Amount on P60) CURRENT WEEKLY TAKE HOME PAY ANY OTHER INCOME PLEASE GIVE DETAILS: (e.g. Social Welfare Payment) OTHER FINANCIAL COMMITMENTS (loans, etc) Yes No Yes No IF YES PLEASE GIVE DETAILS Please state loan amount, lending agency and monthly repayments. Lending Agency Amount of Loan Repayments Date Loan Ends

3 Employment history for last 5 years (From present date back). Occupation of Applicant(s) Employer(s) Period of Employment From To Weekly Gross Pay Monthly A. - Present B. C Occupation of Applicant(s) Employer(s) Period of Employment From To Weekly Gross Pay Monthly A. - Present B. C Give details of where you have lived for the last ten years: (i) (i) Date: From / / To / / Date: From / / To / / (ii) (ii) _ Date: From / / To / / Date: From / / To / /

4 (iii) (iii) _ Date: From / / To / / Date: From / / To / / Have you at any time in the past been convicted of a criminal offence Yes No If yes, please give details of offence, date of conviction, sentence served etc: Details of your present Accommodation: Are you: In private rented Accommodation Yes No Yes No Sharing with Another household Yes No Yes No Living with parents Yes No Yes No Other Yes No Yes No Please give details Property Owned or Previously Owned or Jointly Owned by Applicants 1. Has either applicant ever owned or jointly owned a house Yes No Yes No If Yes, Please state Address Reason for selling/disposal Original Purchase Price Amount of Mortgage Date of Leaving No. of years owned 2. Do you currently own any house land or any other property? Yes No Yes No If Yes, Please state Address Valuation

5 Please give details of your dependents: NAME RELATIONSHIP TO APPLICANT DATE OF BIRTH PPS NUMBER DECLARATION I/We declare that the information given by me/us in this form is correct to the best of my/our knowledge and belief. I/we authorise Kerry County Council to make all enquiries it considers necessary in considering my application. Signature of Each Applicant: Date: Date: IMPORTANT NOTICE Please note that this application is intended to assist Kerry County Council in determining eligibility for inclusion on the Affordable Housing List under Part V of the Planning and Development Acts 2000 and 2002 and it does not guarantee an offer of accommodation. Tenant/Tenant Purchasers of a Local Authority or Tenants of a Voluntary Housing Association who are offered an affordable property must surrender their dwelling to the Local Authority/Voluntary Housing Association prior to taking up occupation. No discount will be made on the purchase price in respect of the annuities paid during periods of tenant purchase. Kerry County Council may require documentary evidence to support an applicant(s) eligibility for inclusion on the Affordable Housing List and their eligibility for any draw held. In respect of first time buyers, the Inspector of Taxes must certify that the applicant(s) have not previously claimed income tax relief in respect of interest paid to purchase or build a dwelling.

6 The purchaser of any affordable property under Part V of the Planning and Development Acts 2000 and 2002 must notify Kerry County Council in writing if he/she proposes to resell the dwelling within twenty years from date of purchase. The proceeds of the re-sale of an affordable property will be subject to a claw-back in accordance with the terms and conditions of the Affordable Housing Scheme. Applicants who have to the knowledge of Kerry County Council participated in anti-social behaviour activities will not be eligible for affordable housing and will be advised accordingly. In order to ensure the best possible use of affordable properties only larger households will be considered for larger properties and smaller households for smaller properties. For example, on the basis of housing need single purchasers may be considered for studio or one-bedroom properties, joint purchasers for one or two bedroom properties etc. Purchasers of an affordable housing property will be required to reside in the property as their full time residence. The information you give must be true and accurate. Failure to provide true and correct information will disqualify applicant(s) from eligibility for affordable housing. If your circumstances change you must notify Kerry County Council. Failure to do so may disqualify you at a later stage. No agreement enforceable at law will be created or intended to be created, until contract documents are executed. PLEASE NOTE: INCOMPLETE APPLICATIONS CANNOT BE ACCEPTED AND WILL BE RETURNED TO APPLICANTS FOR COMPLETION. DOCUMENTATION REQUIRED WITH THIS APPLICATION: Copy of Birth Certificate for each applicant and child/dependant. P60 for previous tax year. Two current payslips from your employer for each applicant. Letter from employer confirming that your employment is permanent. (for each applicant). Certified details of total amount of Social Welfare Payments received during the previous tax year, if applicable. Details of current weekly Social Welfare Benefits, if applicable. For self-employed persons, audited accounts in respect of previous 3 years and current Notice of Assessment from the Tax Office. Documentary evidence of rent repayments if presently in private rented accommodation. Completed Inspector of Taxes Certificate (First Time Buyers).

7 CERTIFICATE OF TAXES Full Name Previous Name (if any) Present Address Applicant 1 Applicant 2 Previous Address (if any) P.P.S. Number Any other relevant information: To be completed by Inspector of Taxes I HEREBY CERTIFY in accordance with my records and to the best of my knowledge and belief that the above named applicants (1 & 2) have not previously claimed Income Tax Relief in respect of interest paid on money borrowed to purchase or build a dwelling. Signed: Dated: Official Stamp

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