Premises left unoccupied by person who are in hospital, nursing home or in a residential care home

Premises left unoccupied by person who is in hospital, nursing home or in a residential care home

About your data
We will ask you for information in order to handle your request and we may use it to contact you. Our privacy policy explains how we handle your personal data.
Name of account holder
First name
Last name
Address of property
Address line 1
Address line 2
Town or city
Postcode
Account reference
Name of the occupant who now resides in the nursing or care home
Date they moved into the nursing or care home
Name and address of the nursing or care home
Does anyone else remain living in the property?Yes No
Name
Date of birth (dd/mm/yyyy)
Name
Date of birth (dd/mm/yyyy)
Are you the account holder?Yes No
I would like to receive text alerts to get a reminder
Mobile number
I would like to receive my bill via email. (Please note that once you have opted in, all bills will be sent electronically and not posted)
Email address
Confirm email address
By submitting this form you are consenting to receiving text alerts/ebills/information from us. We will not share this information with any third parties. You can change your mind at any time if you no longer want to receive text alerts/ebills/information from us. If you do change your mind, please contact Team name by emailing team.name@basingstoke.gov.uk or calling 01256 844844.
Name
Address
Telephone number
Email
Relationship to account holder
To help us avoid abuse of our system, please enter the correct answer to the question below:

Do fish swim in the sea or sky?

Premises left unoccupied by persons who are in hospital, nursing home or in a residential care home