Part 6 Your outgoings and expenses – Amount How often? Housing costs and utilities paid (weekly, monthly) Rent £ Council tax £ Buildings insurance £ Contents insurance £ Gas No ☐ Yes ☐ £ Pre-paid meter? Electricity No ☐ Yes ☐ £ Pre-paid meter? Water rates £ fuel (please specify) ____________________________ £ ☐ ☐ Are you in arrears with any of your housing costs or utilities? No Yes If yes, please tell us which ones are in arrears and how much the arrears are. If any of your housing costs or utility expenses are unusually high, please tell us why here. Amount How often? Personal expenses paid (weekly, monthly) Clothing £ Grocery shopping (food, toiletries, cleaning etc.) £ School meals £ Child maintenance payments £
Part 6 – Your outgoings and expenses Housing costs and utilities Amount paid How often? (weekly, monthly) Rent £ Council tax £ Buildings insurance £ Contents insurance £ Gas Pre-paid meter? No ☐ Yes ☐ £ Electricity Pre-paid meter? No ☐ Yes ☐ £ Water rates £ fuel (please specify) ____________________________ £ Are you in arrears with any of your housing costs or utilities? No ☐ Yes ☐ If yes, please tell us which ones are in arrears and how much the arrears are. If any of your housing costs or utility expenses are unusually high, please tell us why here. Personal expenses Amount paid How often? (weekly, monthly) Clothing £ Grocery shopping (food, toiletries, cleaning etc.) £ School meals £ Child maintenance payments £
discretionary-housing-payments-dhp-form.docx