1 2 The person named is Connected Ownership Details if applicant is not also Owner Business Partner Co-owner If ‘other’ state connection below e.g. “Trustee” Owner Other Full Name Address Post Code 1.2.24 1.2.25 e-mail address 1.2.26 1.2.27 Date of Birth (not for companies) Unique Reference Number or Tel. No. Fax No. 1.2.28 Companies House Registration Number 2 2
1.8.7 If you have answered “Yes” to question 1.8.6, how many smoke alarms are fitted (including heat alarms)? Note: The positions of these alarms will need to be shown on a property plan (see Section 10) 1.8.8 If you have answered “Yes” to question 1.8.6, has the fire alarm system been inspected by a competent person in the 12 months preceding the date of this application? Please tick If your answer to this question is “Yes” please enclose the inspector’s test report (See Section 11 - Enclosures) Yes No 1.8.9 Is the property fitted with an emergency lighting system to the communal hallway(s), staircase(s) and landing(s)? Please tick Yes No 1.8.10 If you have answered ”Yes” to question 1.8.9, has the emergency lighting system been inspected by a competent person within the 12 months preceding the date of this application? Please tick If your answer this question is “Yes” please enclose the inspector’s test report (See Section 11 - Enclosures) Yes No 1.8.11 Do you supply, as part of any tenancy in the property, any upholstered furniture to which the Furniture and Furnishings (Fire)(Safety) Regulations 1988 (as amended) apply? Please tick Yes No 1.8.12 If your answer to question 1.8.11 is “Yes”, can you confirm that all such upholstered furniture complies with the relevant fire safety criteria? Please tick Yes No
Form 2 Part 4 Connected Ownership 2.4.1 The person named is Business Partner Co-Owner If ‘other’ state connection below e.g. “Trustee” Owner Other 2.4.2 Full Name 2.4.3 Address 2.4.4 Post Code 2. 4.5 Tel. No. 2.4.6 e-mail address 2. 4.7 Fax No. 2.4.8 Date of Birth (not for companies) 2.4.9 Unique Reference Number or Companies House Registration Number Connected Ownership 2.4.10 The person named is Business Partner Co-Owner If ‘other’ state connection below e.g. “Trustee” Owner Other 2.4.11 Full Name 2.4.12 Address 2.4.13 Post Code 2. 4.1 4 Tel. No. 2.4.15 e-mail address 2. 4.1 6 Fax No. 2.4.17 Date of Birth (not for companies) 2.4.18 Unique Reference Number or Companies House Registration Number Connected Ownership 2.4.19 The person named is Business Partner Co-Owner If ‘other’ state connection below e.g. “Trustee” Owner Other 2.4.20 Full Name 2.4.21 Address 2.4.22 Post Code 2. 4.2 3 Tel. No. 2.4.24 e-mail address 2. 4.2 5 Fax No. 2.4.26 Date of Birth (not for companies) 2.4.27 Unique Reference Number or Companies House Registration Number Continue on a separate or photocopied sheet if necessary
WEST MIDLANDS HOUSING FORUM Application for a Licence to Operate a House in Multiple Occupation (HMO) Housing Act 2004 Part 2 If the details you give in this form are the same for each of your applications there is no need to fill in a new form for each application. Just fill in the main part of the form once and photocopy as many copies as you need A useful approach would be to fill in all the boxes where the details given are the same for each property and photocopy the form. Then fill in the blank boxes with the information which varies from property to property Each form must have the property address and signature sections filled in individually Photocopied or facsimile signatures will not be accepted 4.1 Basic Details 4.1.1 Address of Property 4.1.2 Proposed Licence Holder’s Name Proposed Licence Holder’s Unique Reference Number (or Company Registration Number) 4.1.3 Before issuing a licence, the Council is required to be satisfied that the management arrangements for the property are satisfactory. The following questions are designed to assess the procedures you have, or intend to have, in place to ensure good management of the property. It does not matter too much if you are unable to answer some of the questions. An example answer is given alongside each question Question Your Answer Example Answer (not necessarily the ideal answer) 4.2 Fire Safety 4.2.1 What arrangements are in place to ensure that fire detection and warning devices continue to work correctly? All visible detectors checked by manager monthly for damage or warning indicators. Every 6 months I test the alarm system to check it is working and can be heard throughout the building. I keep a book on the premises which records these checks. 4.2.2 What measures are there to ensure that the escape routes are kept free of obstructions and that the final exit doors are openable from the inside without the use of a key? I check for obstructions each time I visit and if I find any I warn tenants that they must be removed immediately. If they are not removed I dispose of them myself.
4.6.2 If you have an intruder alarm with an audible sounder, what arrangements are there to ensure that activations and false alarms are properly dealt with and that the sounder is silenced within a reasonable time? Mention the procedure to be followed if the alarm sounds when the house is unoccupied The alarm system has been explained to all the tenants. They all have the code to silence the alarm and there’s a card by the control panel reminding them what to do. I have given my emergency number to neighbours and have informed the noise people at the council who they should contact if anyone is annoyed by it. 4.7 Tenancy Management 4.7.1 Has each tenant been provided with a true copy of a written tenancy agreement or a written statement of the terms on which they occupy the property? Yes, they are all given a copy at the start of their tenancy and further copies are available on request Is the tenants’ rent payable weekly, monthly or over some Weekly, but I give my tenants a written receipt for each payment 4.7.2 other term? If weekly, is a rent book provided? I enforce a general rule that no- 4.7.3 What arrangements have been made for minimising potential problems between tenants? Such problems might include noise, use of one can play music which can be heard in other rooms after 11pm. Otherwise most people seem to get on OK. hot water, sharing cooking equipment etc. 4.7.4 What procedures do you have to deal with disputes between tenants? I don’t usually have any problems but if I did have a dispute of some kind I would try to involve some independent arbitrator What procedures will you adopt if you are satisfied that a particular tenant is the cause of of anti-social I would discuss the matter with the tenant and warn them in writing that continued trouble will lead to 4.7.5 behaviour towards people sharing the property or them being evicted people living in the neighbourhood?
To: Name and Address of person you must notify 5.1.1 5.2.1 This document is to inform you that I Your Full Name 5.2.2 of Your Address 5.2.3 My telephone number is Your Telephone Number 5.2.4 My e-mail address is Your e-mail Address 5.2.5 Intend on Intended Date of Application 5.2.6 To apply under Part 2 of the Housing Act 2004 to Name of Local Authority 5.2.7 for an HMO licence in respect of Address of HMO to be licensed 5.2.8 The licence holder will be (if not you) Licence Holder’s Name 5.2.9 of Licence Holder’s Address 5.2.10 The licence holder’s telephone number is Licence Holder’s Tel. Number 5.2.11 The licence holder’s e- mail address is Licence Holders e-mail address Signed Licence Applicant(s) Date
5.3.1 Address of Property I/We declare that I/we have served a notice of this application on the following persons who are the only persons known to me/us that are required to be informed that I/we have made this application Name Address Description of the Date of 5.4.1 person’s interest in the property or the service application 5.4.2 5.4.3 5.4.4 5.4.5 5.4.6 Proposed Licence Holder’s Name Proposed Licence Holder’s Unique Reference Number (or Company Registration Number) 5.4.7 Signed Licence Applicant(s) Date: Please continue on a separate or photocopied sheet if necessary