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[null,null,null,null,null,"Landlord request for a Managed Payment / Rent arrears deduction"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"What is the purpose of this form?"]
[null,null,null,null,null,null,null,null,null,null,null,null,"This form is used to request a managed payment or a rent arrears deduction, or both."]
[]
[]
[null,"This is a request for:\n(tick only one option)",null,null,null,"       Managed Payment of"]
[null,null,null,null,null,"       Housing Cost Element",null,null,null,null,null,null,"What is a Managed Payment or a Rent Arrears Deduction?"]
[null,null,null,null,null,"       Rent arrears",null,null,null,null,null,null,"When a tenant has accrued arrears to the value of two month's rent or more,\nwe can make managed payments to you as their landlord.  We can also take steps to recover any rent arrears through deductions from their Universal Credit payment"]
[null,null,null,null,null,"       Both"]
[null,"Tenant Details"]
[]
[null,"Tenant Name"]
[null,null,null,null,null,null,null,null,null,null,null,null,"When a tenant has accrued arrears to the value of one month's rent due to repeated underpayment, we will look at personal budgeting support for them and consider making managed payments to you as their landlord, if appropriate."]
[null,"Partner Name (if applicable)"]
[]
[null,"Address"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"What information must I provide?"]
[]
[null,"Claimant DOB",null,null,null,"/          /"]
[null,null,null,null,null,null,null,null,null,null,null,null,"The following evidence must also be provided before a managed payment and deductions can be considered:"]
[null,"Partner DOB",null,null,null,"/          /"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"1. Proof of rent arrears. This must show the current balance on the rent account including the amount of rent outstanding and the amount of rent due on each "]
[]
[null,"Tenant's reference number. ",null,null,null,null,null,null,null,null,null,null,"payment period.  A rent book, rent statement or letter from yourself addressed to the tenant on letter-headed paper, are all acceptable."]
[null,"(BACS payment identifier)"]
[]
[null,"Rent payment frequency",null,null,null,null,null,null,null,null,null,null,"2. A full breakdown of exactly how the rent arrears have been calculated, e.g. the period over which the arrears have accrued.  "]
[]
[]
[null,"Amount of rent payable (£)",null,null,null,null,null,null,null,null,null,null,"3. A full breakdown of exactly how the rent amount is calculated (e.g. service charges, water rates, tv aerial fees, etc.)"]
[null,"Service charge (£)",null,null,null,"e.g £1.49",null,"Details","e.g Gardening"]
[null,"Service charge (£)",null,null,null,null,null,"Details"]
[null,"Service charge (£)",null,null,null,null,null,"Details",null,null,null,null,"Where to send this form:\n\nemail address TBC"]
[null,"Service charge (£)",null,null,null,null,null,"Details"]
[null,"Service charge (£)",null,null,null,null,null,"Details"]
[null,"Service charge (£)",null,null,null,null,null,"Details"]
[null,"Total payable (£)"]
[]
[]
[null,"Number of rent free weeks  \n( zero if none)"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"Once we have received the completed form and evidence, a decision will be made whether to make a managed payment and deductions. \n\nWe will advise you and your tenant of the decision in writing. "]
[null,"Number of bedrooms"]
[]
[null,"Joint Tenancy (Yes/No)"]
[]
[null,"Amount of arrears (£)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"UC47"]
[]
[]
[null,null,null,null,null,null,null,null,null,"PTO","UC47"]
[]
[null,"Landlord Details"]
[]
[null,"Full Name"]
[]
[null,"Address"]
[]
[]
[null,"Telephone Number"]
[]
[null,null,null,null,null,null,"Tier 1",null,null,"Tier 2"]
[null,"Reason for APA request:",null,null,null,1.1000000000000001,null,null,2.1]
[null,"(Tick all factors that apply) ",null,null,null,1.2,null,null,2.2000000000000002]
[null,null,null,null,null,1.3,null,null,2.2999999999999998]
[null,null,null,null,null,1.4,null,null,2.4]
[null,null,null,null,null,1.5,null,null,2.5]
[null,null,null,null,null,1.6,null,null,2.6]
[null,null,null,null,null,1.7,null,null,2.7]
[null,null,null,null,null,1.8,null,null,2.8]
[null,null,null,null,null,1.9,null,null,2.9]
[null,null,null,null,null,1.1000000000000001,null,null,2.1]
[]
[null,"Rent Arrears Details"]
[null,"Do you want to apply for a Third Party Deduction to repay existing rent arrears? Yes/No"]
[]
[]
[null,"If 'Yes' please provide your Department for Work and Pensions creditor "]
[null,"reference number(if known)"]
[]
[]
[null,"Date",null,null,null,null,null,null,null,null,"UC47",null,null,null,null,null,null,null,null,"v1.0   3/14"]
[]
[]
["FM Rent Arrears Landlord/Claimant Managed Payment Request Form",null,null,null,null,null,null,null,"v1.0   3/14"]