Mutual Exchange Application Form

YOUR DETAILS

Tenant Name*

First NameLast Name

Joint Tenant Name (if applicable)

First NameLast Name

Address of Current Tenancy*

Street Address

Street Address Line 2

CityCounty

Postal Code

Phone Number*

Area CodePhone Number

Mobile Phone Number

Email

example@example.com

Details of Special Adaptations to Property*

If no adaptations, state 'none'

House Size and Type*

Do you, or anyone in your household have any requirement for specific adaptations to a property? Please provide details.

If none required, state 'none'

PROPOSED EXCHANGE TENANT(S) DETAILS

Name*

First NameLast Name

Joint tenant name (if applicable)

First NameLast Name

Address of Proposed Exchange Tenant(s)

Street Address

Street Address Line 2

CityCounty

Postal Code

Phone Number

Area CodePhone Number

Mobile Phone Number

Email

example@example.com

Who is their landlord?

Details of your household (including the tenant(s))*

	Name	Date of Birth	Sex	Relationship to Applicant
1.
2.
3.
4.
5.
6.

Details of Previous Addresses (for the last 5 years)

	Address	Date from	Date to	Reason for leaving
1.
2.
3.
4.

Do you have any pets?*

If yes, please provide details

Are you on our waiting list for re-housing?*

YesNo

Please provide application reference

Reason for requesting an exchange*

Please provide full details

Have you, or anyone living with you been evicted for anti-social behaviour or been served with an Anti-Social Behaviour Order (ASBO)?*

YesNo

If yes, please provide the name of the person and the date the ASBO was granted and the name and address of the landlord at the time it was served.

Are you, or anyone to be rehoused with you required to register with the police under the Sexual Offenders Act 2003 or any other reason?*

YesNo

If yes, please give details of the person registered.

GUIDANCE NOTES

1. A Scottish Secure Tenant is entitled to make an application for a mutual exchange with another tenant of a registered social landlord or local authority.

2. The landlords written approval is required.

3. The proposed exchange is subject to routine tenancy checks and a property inspection.

4. All cases will be considered on their own merits and permission will not be withheld unreasonably.

DECLARATION

I/we have read the guidance notes above and declare that the information given on this form is correct.

I/we also understand that to give false information at any time may result in the change of tenancy being cancelled and/or legal proceedings being initiated to terminate the tenancy.

I/we authorise Orkney Housing Association to make relevant enquiries with other services and external agencies to confirm the details I/we have given on this form or to request information to support my/our application for a mutual exchange.

Signature of present tenant*

Signature of present joint tenant (if applicable)