Current Start Preview Complete Information message Filling out this form will email the relevant department See also our Revenue and Benefits Privacy Notices Council Tax account number Your details Name Customer name Title Title - Select -MissMsMrMrsDrOther… Enter other… First Last Address Customer address Address Address 2 City/Town Post Code Contact details Email Phone number Other details Date of birth National Insurance Number Household Information Does anyone else live with you, including children? Yes No Person 1 Please list all other residents living with you including other children and other adults: Full name Date of birth National Insurance Number Relationship to you Source of income (if any) Add another person Yes No Person 2 Please list all other residents living with you including other children and other adults: Full name Date of birth National Insurance Number Relationship to you Source of income (if any) Add another person Yes No Person 3 Please list all other residents living with you including other children and other adults: Full name Date of birth National Insurance Number Relationship to you Source of income (if any) Add another person Yes No Person 4 Please list all other residents living with you including other children and other adults: Full name Date of birth National Insurance Number Relationship to you Source of income (if any) Add another person Yes No Person 5 Please list all other residents living with you including other children and other adults: Full name Date of birth National Insurance Number Relationship to you Source of income (if any) Add another person Yes No Person 6 Please list all other residents living with you including other children and other adults: Full name Date of birth National Insurance Number Relationship to you Source of income (if any) Claim Backdate Do you want us to backdate your award? Yes No CTS can be backdated for a maximum period of one month if you are working age or a maximum of three months if you above pension age. If you wish to apply, please explain why you didn’t apply sooner and the date you would like your CTS backdated to. Reason for not applying sooner Date you would like your CTS backdated to 13337
