Priority Pass Application Form - Sustainable Homes

1 Overcrowding/Under OccupyingPriority pass Application form Freephone 0800 328 7932 or visit us at Accommodation incorrect size Overcrowding / Under Occupying Priority can be given for overcrowding on a low, medium or high level and for under occupying on a low, medium or high level. All rooms in your existing accommodation which are bedrooms or could reasonably be used as bedrooms will be taken into account. Overcrowding Priority will be awarded where: Children over the age of 8 of the opposite sex share a bedroom; Children over 14 of the same sex share a bedroom; There are inadequate bed spaces for the number of persons in the household; If you lack one bedroom / bed space due to the ages of children sharing you will be awarded a low Priority Bronze pass If you need an additional bedroom / bed space due to the size of your household you will be awarded a medium Priority Silver pass If you need two or more bedrooms due to the size of your household you will be awarded a high Priority Gold pass If you are under occupying a larger property and want to downsize to a smaller property we will award a Priority on the basis of the extra rooms in your home.

2 If you have one extra bedroom than your household requires you will be awarded a low Priority Bronze pass If you have two or more bedrooms than your household requires you will be awarded a medium Priority Silver pass If you are awarded a Priority for overcrowding or under occupying you can limit your pass to certain accommodation types or locations (: see list included in information pack). Freephone 0800 328 7932 or visit us at Limiting Your pass : If awarded a pass I would want to limit this to the following locations/types of properties: Locations: _____ Types: _____ Application Registration No. (must be filled in) About You You Name:_____ Your Address:_____ _____ Telephone No:_____(home)_____(mobile) About Your House How many double bedrooms are there in your property?

3 _____ How many single bedrooms are there in your property?_____ You have already given us details of your household who will move with you, please provide details of anyone else living with you who will not move with you: Name: Date of Birth: Relationship ( father) _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ Freephone 0800 328 7932 or visit us at Confirmation: I confirm that the information I have given is correct. I have read and understand the Associations Policy in relation to supplying false or misleading information. I agree to the use of this information in accordance with the data protection statement as stated in the Guide to homehunt Caledonia. Signed:_____ Date:_____ Please not we may ask for further information to verify this Application or to visit you at home.

4 When complete and signed, return this form to: Caledonia Housing Association, 118 Strathern Road, Broughty Ferry, Dundee, DD5 1JW Tel: 01382 480915 Fax: 01382 480151 Email.