Housing Application Form

What you’ll need

Towards the end of your application, you will be asked to provide copies of various documentation. Please have these ready to upload. Your application will not be made active until all necessary required documents have been received. Each person named on the application will need to provide items from the following lists.

List A – each applicant to provide ONE proof from this list:

Passport (current or expired)
National Identity Card (current or expired)
Registration certificate or document (current or expired) certifying or indicating permanent residence issued by the Home Office to a national of the EEA
An immigration status document containing a photograph issued by the Home Office to the holder with an endorsement indicating the named person has ‘indefinite’ leave in the UK or has ‘no time limit’ on their stay in the UK
A certificate of registration of naturalisation as a British citizen

List B – each applicant to provide TWO required documents from this list:

A current full or provisional photo card UK driving licence
Benefits paperwork issued by HMRC, a UK Local Authority or Job Centre Plus on behalf of DWP, issued within the three months prior to the check
Full birth or Adoption certificate issued in the UK, Channel Islands or Isle of Man
HM forces identity card or other document of confirmation, or letter issued by the Secretary of State of the applicant’s current or previous service in any of the UK armed forces
A letter from HM Prison Services confirming applicant’s name, date of birth and that they have been released from custody of that service in the 6 months prior to the check, or a letter from the National Offender Management Service if issued within three months prior to the check.

If you own your home, you will also need to provide a recent valuation of your home. If you rent your home, you will need to provide your landlord details so that we can obtain a reference.

In Addition

EACH applicant to provide copies of 3 x months’ worth of bank statements, for all bank accounts held.

Take your time

This application form asks for a lot of details and will take some time to complete. We recommend you save the form regularly and copy the given link so that you can come back to the form at a later time. We also recommend you get a cup of tea before you start!

Your Application Reference Number:

For reference, please tell us your name and contact details. We’ll ask about the applicant(s) in the next step. We’ll only use your information in relation to this application.

First Name

Last Name

Phone/Mobile

Email

Is this a joint application?

No – I’m the sole applicant

Yes – I’m applying for me and someone else

Please Note: We are not able to accept applications from persons under the age of 50.

Applicant Details

1st Applicant Details

First Name

Last Name

Date of Birth

Email

Phone/Mobile

PFH may contact this applicant by

Phone

Email

Either

Gender

Marital Status

Sexual Orientation

Religion

Ethnicity

2nd Applicant Details

First Name

Last Name

Date of Birth

Email

Phone/Mobile

PFH may contact this applicant by

Phone

Email

Either

Dropdown

Marital Status

Sexual Orientation

Religion

Ethnicity

About your current home

Do you have any pets?

Yes

No

Pet Details

Are you currently homeless?

No

Yes

I will be soon

Please attach proof of statutory homelessness from the local authority

Choose File

Please explain your current circumstances

Current Address

Address Line 1

Address Line 2

City

County

Post Code

Property Type

Tenure

Are you registered on the Hull City Council’s housing register?

Yes

No

Please provide a recent valuation of your home. Please note that if the value of your property and any savings you have, exceed £235,000 then you will not meet the criteria for one of our properties. Unfortunately we cannot accept valuations from Zoopla.

Valuation Upload

Choose File

Main Applicant Address History

Please provide your address history over the last 5 years. Add more rows as required.

Previous Addresses

Previous Address	Tenure	Time at Property	Reason for leaving	Landlord Name & Address

Applicant 2 Address History

Please provide the address history of the joint applicant over the last 5 years. Add more rows as required.

Tick this box if the address details are the same as Applicant 1

Previous Addresses

Previous Address	Tenure	Time at Property	Reason for leaving	Landlord Name & Address

Please tell us the reasons your current property is not suitable and how moving to a PFH property will improve your day to day living.

Declaring whether you know anyone who works within PFH, or is a Board Member, is important as part of this application. We’d also like to understand how you heard about us, so we can continue to improve how we work.

How did you hear about PFH?

Are you a close relative or friend of a PFH member of staff or Board Member?

Yes

No

Have you ever lived in a PFH property before?

Yes

No

We would now like to understand your property preferences.

Please note that if you are applying for a property with a shared communal entrance and you have a pet we will consider the request as part of your application or if you are being considered for a property.

Please confirm your age (for main applicant):

How many bedrooms are you applying for?

We have a small number of adapted properties which suitable for those who use a wheelchair. Please tick if you require an adapted property.

Which area are you applying for?

West Hull

East Hull

North Hull

East Yorkshire

North Hull

1-Bedroom Properties

North Hull 1 Bed

Ada Holmes Circle (1 x bed bungalows) (Age 60+ only)

Ada Holmes Circle (1 x bed houses)

Westgarth Avenue, Oldstead Avenue (1 x bed bungalows) (Age 60+ only) HIGH DEMAND, LIST CLOSED

2-Bedroom Properties

North Hull 2 Bed

Ada Holmes Circle (2 x bed bungalows) (Age 60+ only)

Ashbury Court, Endike Lane (2 x bed bungalows) (Age 60+ only)

Green Close (2 x bed bungalows)

Padstow Close (2 x bed bungalows) (Age 60+ only) AVAILABLE LATE SUMMER 2024

Westgarth Avenue, Oldstead Avenue (2 x bed bungalows) HIGH DEMAND

3-Bedroom Properties

North Hull 3 Bed

Ada Holmes Circle, Greenwood Avenue (3 x bed house)

East Yorkshire

1-Bedroom Properties

East Yorkshire 1 Bed

Main Street, Tickton (1 x bed houses)

Mereside, Hornsea (1 x bed apartments)

Richardson’s Court, Bridlington (1 x bed apartments)

2-Bedroom Properties

East Yorkshire 2 Bed

Welwick Road, Patrington (2 x bed bungalows) HIGH DEMAND, LIST CLOSED

The following questions apply to you or anyone who is moving with you.

	Yes	No
Are you in rent arrears with a current or previous landlord?
Have you been evicted from a property or served a Notice to Quit?
Do you have any spent/unspent convictions spent/or convictions?
Have you been involved in any harassment issues or anti-social behaviour?
Do you have any CCJs or Criminal Behaviour Orders?
Do you require a ground floor property due to mobility reasons?
Do you require level-access shower facilities?

If you answered yes to any of the questions regarding you or anyone moving with you, please provide as much information as possible.

Affordability

This basic affordability check is designed to ensure that you can afford to live in a PFH property without falling into financial difficulty. Questions must be answered fully so that we can support you with maintaining your occupancy or help you find the financial advice services you may need. Please note if this form is not returned or is incomplete, it will result in the suspension of any offer of accommodation.

All Capital and Savings

£

Total Monthly INCOME

£

Total Monthly OUTGOINGS

£

Total Monthly disposable income

£

After paying rent and bills along with other miscellaneous expenditure, are there funds remaining at the end of each week?

Yes

No

Your Health

So we can better match you to a property that meets your requirements, please provide us with details about your health and current circumstances.

Checkbox Grid

	Yes	No
Do you consider yourself to have a disability?
Are you registered as disabled?
Are you experiencing Anti-Social Behaviour (ASB)?
Are you experiencing domestic abuse?
Are you unable to return home from hospital or respite because your accommodation is unsuitable due to health/mobility issues?

Is there anything else you would like to tell us related to your health?

We’ll now ask you some questions to help us assess your circumstances. Please select the most relevant answer in each case.

Pleases select the answer that best describes your circumstances surrounding housework

I can manage housework

I cannot manage housework and would still need help if living in more suitable housing

I need help with housework but could manage more independently if home was smaller and I could access all rooms

Please select the answer that best describes your circumstances relating to shopping and attending appointments

I cannot manage shopping as I am too far away but could do it if shops were closer

I do my own shopping and attend appointments independently

I need to be taken shopping because I cannot walk around easily or carry the shopping

Please select the answer that best describes your circumstances relating to stairs and steps

I live in an upper floor flat with no lift access and stairs are a struggle

I live in one level accommodation and can access all rooms independently

I sleep downstairs in living room all the time because I cannot manage stairs to access upstairs bedroom or bathroom and no toilet available downstairs

I sleep downstairs in living room all the time because I cannot manage stairs to access upstairs bedroom or bathroom but have toilet downstairs

Tell us about your heating

My property is partially heated

Property has heating which does not work efficiently

No central heating

None of the above

Repair of your home

Property needs minor repairs

Property needs major repairs (please note you will be required to provide evidence)

None of the above

Managing your garden

I do not have a garden

I can manage my garden

I am finding it difficult to maintain my garden

I do have a garden but someone else has to maintain

My garden is overgrown and I cannot afford private gardener and/or has no relatives

My garden is communal

Using your Bathroom

I can manage to use by bathroom independently

I need supervision/support from family or carer with personal hygiene/when using my bathroom

Are your current bathing facilities suitable for your needs?

Yes

No

Please tell us why

Please select the answer that best describes your circumstances regarding mobility aids

Do not use any mobility aids or we can use mobility aids safely in the home

Property is unsuitable for the major adaptations that are required

Use a wheelchair all the time inside and outside and property unsuitable as I require a disability or suitably adapted property

Use other mobility aids and my property is unsuitable to use them properly or safely

Which of the following BEST describes your current housing circumstances?

I/we do not live in shared accommodation

I/we live in shared accommodation and do not have own bedroom

I/we live in shared accommodation but have own bedroom

I/we live in temporary accommodation e.g. a caravan

I/we need larger accommodation

I/we need smaller accommodation, it is unmanageable or unaffordable to run and maintain

Please explain why

Please select the answer that best describes your circumstances regarding kitchen and food preparation

Can use the facilities in the kitchen safely and independently

Current kitchen facilities cannot be used safely or independently or allow for independent meal preparation

Have you recently been bereaved and is this influencing your wish to move?

Yes

No

Do you need to move closer to family or friends for practical support or help?

Yes

No

Please provide details

Please select the answer that best describes your circumstances regarding social life

Feeling lonely and isolated and want to move to an area with a Pop In or scheme where there is socialising and ability to meet people

Live close to family or friends and can access the local amenities and social activities if wanting to

Mental health is impacted due to living area

Pleases select the answer that best describes your circumstances regarding affordability of your current home

Can manage all expense related to current home

Cannot afford to pay our mortgage

Live in private rented accommodation and rent is unaffordable

Need to move to a smaller property because bedroom tax has made current property unaffordable

In order to assess your eligibility to join PFH’s waiting list, and also to assess your ‘Right to Rent’ (Immigration Status), you need to provide copies of some documents.

Below is a list of the types of documents that you can use:

Three months’ worth of bank statements and any investments you may hold
ID – Passports, birth certificate etc.
Letters/statements confirming all income received
Housing Benefit and Council Tax benefit information
Valuation from estate agents (we cannot accept valuations from Zoopla)
Landlord details

If you don’t have these documents handy you can hit ‘save & resume’ to come back later and upload them.

How would you like to upload these documents?

Upload here now

Email the documents to PFH

Post or hand-deliver physical copies

Upload files here

Choose File

You can email info@pfh.org.uk with your documents. Please quote the following reference in your email: .

You can post or hand deliver your documents to:

Pickering & Ferens Homes.
7 Beacon Way,
Hull,
HU3 4AE.

Please quote the following reference in your email: .

Declarations

Please read each of the following paragraphs carefully and tick the box to declare you have read and understood each statement.

The data you supply

Our aim is to provide you with the best possible service at all stages. We can only do this if we know about you and your household so we can tailor our services wherever possible to meet your needs, should you be successful. We may share the information within our organisation to deliver or monitor services. We may share information about your needs, health and abilities with our staff, so that they can take account of your particular needs and deliver a quality service. All the information will be processed in accordance with the provisions of the Data Protection Act 2018.

The accuracy of the information you supply

If any of the information given throughout the application process is subsequently found to be false or wrong PFH reserve the right to reject your application. If after verifying the information on this form we find that you have provided false or wrong information then we reserve the right to remove your application from our waiting list or end your Licence.

Existing owned property

In order to comply with the Charity Commission Scheme, those moving from a property which is owned must NOT rent the property out and/or receive a rental income once they are occupying a PFH property.

Data protection and consent to allow us to use your data

By signing the application below and submitting your application to us you will be providing us with your explicit consent to us using the information contained within the application (including sensitive information about people named in the application such as health information and criminal convictions) and any subsequent related correspondence with you for the purposes of processing your application and assessing your suitability and eligibility for a property having regard to our relevant criteria, and discussing your application with you where necessary.

Your right to withdraw your consent

You can withdraw your consent to allow us to use your data at any time. This can be done by e-mailing us at info@pfh.org.uk or writing to us at Pickering & Ferens Homes, 7 Beacon Way, Hull, HU3 4AE. Please note that if you withdraw your consent we will be unable to consider your application any further. Further information in respect of how we will use the personal information contained within the application are set out in our Applicant and Resident Data Protection Statement.

Signature

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