Mutual exchange initial application

First name *

Surname *

Street address and house number *

Postcode *

Email address

Telephone number *

What is the total number of adults and children (including infants) in your household? *

Please list the name and date of birth of everyone in the household, plus their relationship to you

Details of the person you wish to exchange with and their property

Please provide as much information as possible about the person you want to exchange with.

Is this an exchange between two parties only? *

Yes
No

Exchange partner first name *

Exchange partner surname *

Street address and house number *

Postcode *

Telephone number *

What is the total number of adults and children (including infants) in their household? *

Please list the names and ages of everyone in their household and their relationship to the main tenant:

Is any member of the household pregnant?

Yes
No

What type of tenancy do they hold? *

Secure
Assured
Fixed term
Don't know

How many bedrooms does the property have? *

Does the property have any adaptations for disabilities?

Yes
No

Landlord of the proposed exchange property

Landlord's name *

Landlord's address *

Landlord's postcode *

Landlord's email

Landlord's telephone *

Declaration

Please confirm the following *

I am the tenant/legally empowered third party and confirm that the information provided on this form is correct to the best of my knowledge.

Would you like to receive a copy of your submitted information by email?

Yes
No

Communicating with you

Our privacy statement sets out how we look after your personal data.

Would you like to receive information in an accessible format (eg braille, audio)?

Yes
No

Which accessible format would you prefer?

Saturday 21 July 2018

Mutual exchange initial application

Your details

Details of the person you wish to exchange with and their property

Landlord of the proposed exchange property

Declaration

Communicating with you