Housing register review form

Complete this form if you want us to review a decision we have made about your housing application.

Exceptional circumstances:

The council recognises that there may be exceptional circumstances where it becomes necessary to reconsider the qualification criteria in the case of individual applicants who would not normally qualify. The council may reconsider the qualification of these individuals in extreme exceptional circumstances, for example where there is a threat to life and no other housing options are available.

If you would like the council to reconsider if you qualify to join the housing register, explain your exceptional need and attach any supporting information on the following pages.

The information you give in this form is confidential and subject to the requirements of the Data Protection Act 1998. This personal data will be held and processed by Birmingham City Council to help assess your needs and, in particular, the provision of services for which you may be eligible. The personal details you give may also be shared with certain external agencies that help assess and/or give services, as part of any statutory duties requiring such disclosure and to protect the public funds it collects and administers. Any data may be used to prevent fraud or the misuse of resources. You may ask for a copy of your personal information by writing to the Corporate Information Management Team, PO BOX 16366, Birmingham, B2 2YY.

We are committed to preventing and detecting all fraud. It is an offence under the Forgery and Counterfeiting Act 1981 to hold or present false documents such as birth certificates, passports, bank statements and so on, with a view to obtaining goods or services such as temporary accommodation or permanent housing from Birmingham City Council. If we detect fraud, we will take legal action against you.

In submitting this form you are signing this agreement electronically. This is the legal equivalent of a manual signature.