Example of application form and guidance notes
Below are some guidance notes that will help you complete your application and an example of what the application form looks like:
Example of application form
Completing the form
1. Your details
Write your name, address and date of birth on the front page. If you are asking the Trust for help for a different address (where you lived before perhaps) please write this as well
2. Occupants
Please write the name and age of
everyone who usually lives with you
3. & 4. Money coming in
Please write full details of ALL income for everybody in the house. This may be wages or benefits, and you must send proof.
Please also write details of whether payment is received weekly, fortnightly, monthly, 4 weekly, 3 monthly or yearly.
5. Money going out
Please write the amounts of ALL your regular household payments and how often they should be paid. Try to think of everything you spend.
You must send proof of how much you owe for one of your priority debts. This could be for your rent, mortgage, Council Tax, gas, electricity bills, secured loans or court fines.
6. Illness
Please give details of anyone in the household who is seriously ill, long-term sick or disabled. If any extra benefit is received for this please give the details.
Before sending your form back to us you must:
- make sure that you have answered all the questions as well as you can;
- make sure that you are sending proof of ALL Income and a Priority Debt;
- make sure that you have signed and dated the Form, or we will send it back to you;
Remember, you can ring us for help on 0845 1 24 24 26
Important
When filling in the form it is important that you give as much information as you can about your household.
If you have difficulty filling in the form, your local advice centre may be able to help you. Many advice centres offer free and private help with debt problems.
When we get your form:
- we will write to tell you what is happening
- we may ask for proof of anything you have told us
- we may ring or visit you
- we will usually give you a decision within 6 weeks
We will not send any money to you:
If you are successful we will pay the money into your Yorkshire Water account.
Applying to the Trust again:
If you get an award from the Trust you cannot apply again for 2 years.
Request an application form
