Pendle Household Support Fund 7 Application

Pendle Household Support Fund 7 Grant Application
THIS APPLICATION FORM IS CURRENTLY FOR PENDLE RESIDENTS ONLY
Before you begin
1. Your application will take approximately 30 minutes to complete
2. Please ensure you have all supporting information ready to upload: please see application procedure below
Eligibility

To be eligible for the scheme you must be:
1. Aged 18 or over
2. A resident of the Pendle Council district
3. Experiencing financial hardship and struggling to afford essential items or living costs. ( please provide as much detail as possible in your application )
4. Have a household income of below £28,000/year
5. Priority will be given to those that have not received any HSF support since 1st April 2025 from Citizens Advice.
Application Procedure:
1. Complete our short online application form
2. You must provide at least one month of (most recent) bank statements for all open bank/savings accounts held by all adults within the household
3. **We aim to process all applications within 15 working days of receiving all the required information. If you have recieved a payment previously your application will not be assesed as a priority unless there is evidence of an emergency situation in your application.**
4. As part of the application, you may be required to engage in advice and support around your situation. We will provide a call back from a trained adviser in these circumstances, using the contact details you have provided, if you do not engage then we may not proceed with your application.
5. If the required documents are not provided, we cannot proceed with your application.
6. All applications will be closed 10 working days after they have been submitted if the documents are not provided.
7. A copy of your application will be automatically emailed to you for your records.
8. If you are unable to complete this application online, then you can call at any of our offices ( details on our website www.cael.org.uk ) or by calling at our office at The ACE Centre. Cross Street Nelson BB9 7NN. , between 11.00 and 1pm on Tuesdays, please use the buzzer 24 to be let in. You will then be invited into the building to wait in the reception area for a worker to collect you .
Declaration
I understand that the Household Support Fund applications are for those suffering financial hardship, where no other support is available. Further requests for vouchers may be declined if help isn’t sought to address any linked issues causing the hardship.*
Your details
How we use your information:

When we record and use your personal information we:
- Only access it when we have a good reason
- Only share it when it is necessary and relevant. We share anonymised information to the local council to show the number of clients we have supported. We do not sell it to commercial organisations.
Forename and Surname*

First NameLast Name
Gender*
Ethnicity*
Do you have a disability or a long term health condition?*
Date of Birth*

DayMonthYear
Date
National Insurance Number
Address*

Street Address

Street Address Line 2

CityCounty

Postcode
Contact details

Note: We ask for your email address and mobile number (must be for a smartphone) so that we can email or text the voucher codes directly to you.
Mobile phone number*
Email address*
example@example.com
Household information
Please tick all that apply*

SingleCoupleChildren under 18Pension ageHealth conditionsCare Leaver aged 18- 25 year oldOther, please explain
Children living in the Household*
Please provide the number of children and their ages
People of pension age living in the Household*
Please provide the number of people aged 65 or over
Do you receive any of the following Benefits? please tick all that apply*

Attendance AllowanceDisability Living AllowancePersonal Independence PaymentUniversal Credit (UC)Carer's Allowance or Carer's CreditState PensionCouncil Tax SupportPension CreditNoneOther
Is your household income below £28,000/year*
Have you received a Household suppport fund award since 1st April 2025 ? *
Do you currently have an unaffordable debt with your gas or electricity that you would like advice on ?*
Do you currently have any debts that are affecting your ability to afford your essential day-day expenses that you would like advice on*
Are you facing an emergency situation such as eviction or enforcment action*
Please give as much detail as possible on the debts or emergency situation you have indicated above and any times you would not be available for a call back. please be aware the call may come from a witheld number*
Do you have a deduction on your Universal Credit payments?*
Employment*
Reason for Application (please give as much detail as possible )*
Main type of support will be provided by a Charis voucher: What is your preference?*
How would you like us to send this voucher to you?*
Type of support you will purchase with your voucher*
Is there anything else you would like to tell us about or of any issues you have with completing the application?
YOU MUST SEND US THE FOLLOWING BANK DETAILS (SCREENSHOTS ARE NOT ACCEPTED)
Supporting Bank statements for the last full month
- Please upload a copy of your bank statement(s), dated within the last month, that shows your name and address and all transactions for the FULL MONTH
- If you have a partner with a separate bank account, please upload a copy of their bank statement for the last month that shows their name and address and all transactions for the FULL MONTH
- Copies of bank statements for all other accounts you have, such as a savings accounts
- DO NOT send any other documents unless asked
We require all bank statements in relation to your household income. By supplying us with partner and household bank statements, you are agreeing for us to use them in order to assess your eligibility. We only ask for information we need and treat it confidential. Please see our privacy policy for further information.
Please upload bank statements in the box below

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YOU MUST SEND US AT LEAST ONE FORM OF ID OR SUPPORTING DOCUMENTS
At least ONE form of ID or supporting document must be provided.*
Please upload supporting documents in the box below

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- If you are not able to upload your evidence, please call in person at any of our offices.( details on our website ) If calling at our Office The ACE Centre. Cross Street Nelson BB9 7NN. please use the buzzer 24 between 11.00 and 1pm on Tuesdays or note this in your application and we will arrange to receive them some other way.
- If you cannot see the file uploader above, please try deleting cookies in your browser and refreshing this page.
Declaration

By submitting this application I give consent for Citizens Advice East Lancashire to process and use my personal information in order to best support me and use the email address provided to email a copy of the application form to me. I understand that this information will be kept confidential by Citizens Advice East Lancashire.

In order to help you we need to store information about you. The law says we must get your consent to do this. Everything you tell us will be treated confidentially. The information we hold on you will be used solely for the purposes of enabling us to provide you with an effective service. You have the right to make a formal request in writing for access to personal data we hold on you, and to have it corrected if it is wrong. We will not disclose information about you unless the law permits us to, or we have obtained your consent to do so. Updated 08/10/2025
I understand that my application will be closed within 10 days if supporting evidence is not provided.*
I confirm I have appropriate security measures on the device(s) where I receive text messages and emails*
I confirm I have read and understand the declaration above*
Should be Empty:

Pendle Household Support Fund 7 Grant Application

Declaration

Your details

Contact details

Household information

YOU MUST SEND US THE FOLLOWING BANK DETAILS (SCREENSHOTS ARE NOT ACCEPTED)

YOU MUST SEND US AT LEAST ONE FORM OF ID OR SUPPORTING DOCUMENTS