• Membership Application - Selective Licence

  • PLEASE READ

    Your membership of a Home Safe scheme is bound by Membership Terms and Conditions, a General Code of Practice, a Landlord and Tenant Charter, a Maintenance Mandate and our Data Protection Policy. These can all be found on our website under 'Support' then 'The Home Safe Scheme Core Documents' buttons. Please ensure that you have reviewed these documents prior to committing to being a member of Home Safe. Please review the documents here. 

    In order to be a member of a Home Safe scheme you will need to submit this completed form and make payment when invoiced. Once the form has been submitted we will process your application and contact you via email or telephone with any queries, this may take up to 28 days depending upon the amount of applications we have to process. Once you have submitted your application you will receive an acknowledgement email from us detailing what happens next and confirming your application has been received. You will receive an invoice and once paid your membership will be confirmed.

    Please complete your application as thoroughly and honestly as possible, remember we are not the Local Authority, we are here to represent your interests as well as advise and support you. We need to ensure we have all the correct information before putting your details forward for a Selective Licence. If we contact you for any further information, such as omissions, valid certificates or making payments, then once we do you will have 28 days to complete the application. After this time, you will need to re-apply and we must notify the Local Authority that you have failed to submit a complete and correct application. 

    Please note, in addition to a Selective Licence, your property may also require planning consent, if it is a home in multiple occupation, and so you are also advised to make enquiries with Great Yarmouth Borough Council’s Planning Services at plan@great-yarmouth.gov.uk or 01493 846169.

    Please also note it may take up to 30 minutes to complete this form depending on the number of properties you are registering. You will need copies of the relevant certificates to hand, such as Gas, EPC and Electrical. 

    TIP: Only use the back and next buttons at the bottom of each page as the back button on your browser will not move you between pages on this form.

    You must complete this application in one visit as you cannot save and return later.

     

  • Your Details

  • If there is more than one owner of the properties being registered please complete this form using the details of the lead Landlord and then provide additional details of the other owner(s) at the bottom of this page.

  • Are you a member of any other Home Safe scheme?
  • Are you applying on behalf of a business?*

  • This page is only applicable if you are applying as a business, if not applicable please click next at the bottom of this page.

  • Rental Property Details

  • Property 1 

  • If multi let, do you have a fire blanket in all areas with cooking facilities?
  • Is the property furnished, part furnished, or unfurnished?*
  • Please identify any energy efficiency measures already installed at the property*
  • Do you have adequate Smoke Alarms installed at the property?*
  • If you have solid fuel systems at the property, do you have adequate Carbon Monoxide Detectors installed at the property?*

  • Please upload copies of your property documentation below:

  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Are you nominating a Manager or Agent? (please note Agents must be members of the Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

  • Property 2

  • If multi let, do you have a fire blanket in all areas with cooking facilities?
  • Is the property furnished, part furnished, or unfurnished?*
  • Please identify any energy efficiency measures already installed at the property*
  • Do you have adequate Smoke Alarms installed at the property?*
  • If you have solid fuel systems at the property, do you have adequate Carbon Monoxide Detectors installed at the property?*

  • Please upload copies of your property documentation below: 

  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Are you nominating a Manager or Agent? (please note Agents must be members of the Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

  • Property 3

  • If multi let, do you have a fire blanket in all areas with cooking facilities?
  • Is the property furnished, part furnished, or unfurnished?*
  • Please identify any energy efficiency measures already installed at the property*
  • Do you have adequate Smoke Alarms installed at the property?*
  • If you have solid fuel systems at the property, do you have adequate Carbon Monoxide Detectors installed at the property?*

  • Please upload copies of your property documentation below: 

  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Are you nominating a Manager or Agent? (please note Agents must be members of the Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

  • Property 4

  • If multi let, do you have a fire blanket in all areas with cooking facilities?
  • Is the property furnished, part furnished, or unfurnished?*
  • Please identify any energy efficiency measures already installed at the property*
  • Do you have adequate Smoke Alarms installed at the property?*
  • If you have solid fuel systems at the property, do you have adequate Carbon Monoxide Detectors installed at the property?*

  • Please upload copies of your property documentation below: 

  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Are you nominating a Manager or Agent? (please note Agents must be members of the Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

  • Property 5

  • If multi let, do you have a fire blanket in all areas with cooking facilities?
  • Is the property furnished, part furnished, or unfurnished?*
  • Please identify any energy efficiency measures already installed at the property*
  • Do you have adequate Smoke Alarms installed at the property?*
  • If you have solid fuel systems at the property, do you have adequate Carbon Monoxide Detectors installed at the property?*

  • Please upload copies of your property documentation below: 

  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Are you nominating a Manager or Agent? (please note Agents must be members of the Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

  • Property 6

  • If multi let, do you have a fire blanket in all areas with cooking facilities?
  • Is the property furnished, part furnished, or unfurnished?*
  • Please identify any energy efficiency measures already installed at the property*
  • Do you have adequate Smoke Alarms installed at the property?*
  • If you have solid fuel systems at the property, do you have adequate Carbon Monoxide Detectors installed at the property?*

  • Please upload copies of your property documentation below: 

  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Are you nominating a Manager or Agent? (please note Agents must be members of the Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

  • Property 7

  • If multi let, do you have a fire blanket in all areas with cooking facilities?
  • Is the property furnished, part furnished, or unfurnished?*
  • Please identify any energy efficiency measures already installed at the property*
  • Do you have adequate Smoke Alarms installed at the property?*
  • If you have solid fuel systems at the property, do you have adequate Carbon Monoxide Detectors installed at the property?*

  • Please upload copies of your property documentation below: 

  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Are you nominating a Manager or Agent? (please note Agents must be members of the Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

  • Property 8

  • If multi let, do you have a fire blanket in all areas with cooking facilities?
  • Is the property furnished, part furnished, or unfurnished?*
  • Please identify any energy efficiency measures already installed at the property*
  • Do you have adequate Smoke Alarms installed at the property?*
  • If you have solid fuel systems at the property, do you have adequate Carbon Monoxide Detectors installed at the property?*

  • Please upload copies of your property documentation below: 

  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Are you nominating a Manager or Agent? (please note Agents must be members of the Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

  • Property 9

  • If multi let, do you have a fire blanket in all areas with cooking facilities?
  • Is the property furnished, part furnished, or unfurnished?*
  • Please identify any energy efficiency measures already installed at the property*
  • Do you have adequate Smoke Alarms installed at the property?*
  • If you have solid fuel systems at the property, do you have adequate Carbon Monoxide Detectors installed at the property?*

  • Please upload copies of your property documentation below: 

  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Are you nominating a Manager or Agent? (please note Agents must be members of the Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

  • Property 10

  • If multi let, do you have a fire blanket in all areas with cooking facilities?
  • Is the property furnished, part furnished, or unfurnished?*
  • Please identify any energy efficiency measures already installed at the property*
  • Do you have adequate Smoke Alarms installed at the property?*
  • If you have solid fuel systems at the property, do you have adequate Carbon Monoxide Detectors installed at the property?*

  • Please upload copies of your property documentation below: 

  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Upload a File
    Cancelof
  • Action*
  • Are you nominating a Manager or Agent? (please note Agents must be members of the Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

  • The Home Safe Scheme Membership Declaration

  • I understand that by being a member of a Home Safe support scheme I am bound by and agree to act in accordance with the support schemes key documentation. For the purposes of clarity those documents are Membership Terms and Conditions, Any relevent Licence Conditions set by the relevent Local Authority, The General Code of Practice, The Landlord and Tenant Charter, Any other Charters or Documents introduced for your specific area or licence type, The Maintenance Mandate and a Data Protection Policy. I confirm I have have reviewed all these documents, prior to becoming a member of a Home Safe support scheme here.

    I also understand that from time to time the conditions in the above mentioned documents may vary and that it is my responsibility to check the support area of the Home Safe Scheme website for the latest updates.

    I also understand that my personal information maybe used in order for The Home Safe Scheme to communicate to me. NOTE: The Home Safe Scheme values your privacy and will not rent or sell your contact details to any third parties, unless specifically approved by you.

     

  • How would you like to pay for your membership to the support scheme you are joining?*

  • Fit & Proper Person Declaration

  • A fit and proper person is defined in sections 66 and 89 of the Housing ct 2004 and means a person who does not have any relevant unspent convictions and in particular has not:

    - Committed any offences involving fraud or other dishonesty, or violence or drugs or any offence listed in Schedule 3 to the Sexual Offences Act 2003 (i.e. offences attracting notification requirements);

    - Committed any unlawful discrimination on grounds of sex (including within the provisions of the, colour, race, ethnic or national origins or disability in, or in connection with, the carrying on of any business;

    - Contravened any provision of the law relating to housing or of landlord and tenant law; or

    - Acted otherwise than in accordance with any applicable code of practice approved under section 233

    And, during the last five years, neither the applicant nor any person associated or formerly associated with him/her have:

    - Been in control of any property subject to a control order under section 379 of the Housing Act 1985;

    - Been refused a license or had a license removed for any property in relation to HMO, additional or selective licensing under the Housing Act 2004;

    - Been found to have breached a condition on a license for any property in relation to HMO, additional or selective licensing under the Housing Act 2004;

    - Been found by a local authority to have acted otherwise than in accordance with any Code of Practice approved under section 233 of the Housing Act 2004;

    - Been in control of any property that has been the subject of any proceedings by a local authority (such as breaches of the Environmental Protection Act, planning control or compulsory purchase proceedings);

    - Been in control of any property on which the local authority has carried out work in default; or

    - Been in control of any property which has been the subject of an interim or final management order or a special interim management order under the Housing Act 2004.

    We may approach other Authorities such as the Police Authority, Fire and rescue Service, Office of Fair Trading or County Court etc, for information and confirmation regarding your Fit and Proper status.

    By signing this declaration you are agreeing that any such investigations or action can be taken and you are also confirming that none of the above prevents you from qualifying to be a member of the Home Safe Scheme.

    I declare that to the best of my knowledge and belief, the statements made and the information supplied in support of my application for membership of the Home Safe Scheme and any attachments thereto are complete and correct.

  • Declaration to be provided to the Local Authority

  • I declare that the information contained in this application is correct to the best of my knowledge. I understand that I commit an offence if I supply any information to a local housing authority in connection with any of their functions under any of Parts 1 to 4 of the Housing Act 2004 that is false or misleading and which I know is false or misleading or am reckless as to whether it is false or misleading.

    I declare that I have served notice of this application on the persons or companies identified within this application as having an interest in any of the properties being registered and who are required to be informed that I have made this declaration.

    I declare that I am authorised on behalf of all applicants named within this application to make this declaration.

    I authorise Home Safe to provide this information to the Local Authority.

  • Are you an accredited member of any of the following associations?*
  • Should be Empty: