Change of Name/Address and Single Person Discount Form

Please use this form to notify us if you or another household member have changed your name, moved house or require a Single Person Discount.

Please select from the options below if you would like us to inform anyone else.

Mandatory fields are identified with

Your/Movers Name : (or your new name if it has changed)
Title	Forename	Surname

If you are notifying us of a name change, please fill the following:

Old Name
Title	Forename	Surname

Reason For Change

If reason is marriage or divorce, please give name of partner / ex partner
Title	Forename	Surname
Please give effective date of your change of name (dd/mm/yyyy)

Please list how many other members of your household who have also changed their name:

Your/Movers Current or New Address:
House No./Name
Street Name
Area
Town
County
Postcode
Daytime Telephone Number
Email Address

Please select whether you are reporting/requesting a:

: MoveInto Tameside ?
: MoveOut of Tameside ?
: MoveWithin Tameside ?
: Request a Single Person Discount

Your/Movers previous address:
House No./Name
Street Name
Area
Town
County
Postcode
Date moved into new property.	(dd/mm/yyyy)
Date moved out of old property.	(dd/mm/yyyy)
Please list how many other members of your household who also have changed their address:

Who else would you like us to inform ?
If you would like us to notify any of the following services on your behalf complete the relevant fields.
Are you directly responsible for paying Council Tax ?

Are you a member of the Library ?
Library Key Card No:

Do you have school children ?
Pupil Name(s):

Are you a school Governor ?
(if yes, please give school)
Are you a New Charter Housing tenant ?
Are you in receipt of Housing Benefit ?
Are you an Employee of TMBC ?
PRN Number or Service Unit:
Do you have any old accounts for:
Poll Tax ?
Sundry Debts ?
Former Tenant Arrears ?
Form completed by: