Previous Address, if different, in the last 3 Postcode: Do you currently hold a Yes: No: Blue Badge? If you already have a Which local authority issued you Blue Badge: with the badge? What is the serial number on your current badge? What is the expiry date of your current badge? Proof of you address, Either: I give consent to the authority to check my dated within the last 3 personal details on the local authority’s Council Tax months: database so that I do not need to submit proof of my We need to check that address: you are a resident in this Or: I have enclosed a copy of a Council Tax bill bearing my local authority area name and address, within the last 12 months: before we can process your application. Please Or: I do not pay Council Tax and give consent to the local select one of the options authority to check my address on the electoral register: and provide a photocopy of your documentation. Or: I do not pay Council Tax as I am under 16 years old and give the local authority to check school records to confirm my address: of your identity: Either: Birth certificate / adoption certificate You must attach a photocopy of one of the Or: Marriage/ Divorce certificate/ partnership / options given as proof of Dissolution certificate your identity. Or: Valid Driving Licence Or: Passport We need to check your identity and address to reduce the potential of fraudulent applications.
Previous Address, if different, in the last 3 Postcode: Do you currently hold a Blue Badge? Yes: No: If you already have a Blue Badge: Which local authority issued you with the badge? What is the serial number on your current badge? What is the expiry date of your current badge? Proof of you address, dated within the last 3 months: We need to check that you are a resident in this local authority area before we can process your application. Please select one of the options and provide a photocopy of your documentation. Either: I give consent to the authority to check my personal details on the local authority’s Council Tax database so that I do not need to submit proof of my address: Or: I have enclosed a copy of a Council Tax bill bearing my name and address, within the last 12 months: Or: I do not pay Council Tax and give consent to the local authority to check my address on the electoral register: Or: I do not pay Council Tax as I am under 16 years old and give the local authority to check school records to confirm my address: of your identity: You must attach a photocopy of one of the options given as proof of your identity. Either: Birth certificate / adoption certificate Or: Marriage/ Divorce certificate/ partnership / Dissolution certificate Or: Valid Driving Licence Or: Passport We need to check your identity and address to reduce the potential of fraudulent applications.
blue_badge_application_form.docx