Offer of repayment

Please use the form below to detail your income and expenditure and your proposal for repaying your council tax arrears and/or overpaid housing benefit.

Offer of repayment form

Privacy Statement
Basingstoke and Deane Borough Council is the data controller for the personal information you may provide. You can contact us by phone on 01256 844844, via email to customer.service@basingstoke.gov.uk or by writing to us at Civic Offices, London Road, Basingstoke, RG21 4AH. The Council’s Data Protection Officer can be contacted at dpo@basingstoke.gov.uk.
Your information will be used so that we can administer your council tax account and/or overpaid housing benefit and collect council tax and/or overpaid housing benefit from you. Your personal data may be shared with other teams within the council in order to provide a service to you. We may also share it with other local authorities, Valuation Office Agency or debt collection agents if necessary for the collection of council tax and/or overpaid housing benefit. We may share the data with third parties if we are required by law to do so. Please read our privacy statement on how your information is used.
We will keep your details on our council tax and/or overpaid housing benefit database for seven years after you cease to have an account with the council.
Find out about your rights under General Data Protection Regulations (GDPR)
If you are not happy with the way the council is handling your personal information you have the right to lodge a complaint with the Information Commissioner’s Office.
Please tick to confirm that you have read and understood the above privacy statement. *
Title
First name *
Last name *
Best daytime contact number *
Email
Confirm Email
Address 1 *
Address 2
Address 3
Town *
Postcode *
Council tax account/invoice reference *
Your employment details
Name and address of employer *
Payroll number *
Net earnings *
How are you paid? *
Your partner's employment details
Name and address of employer
Payroll number
Net earnings
How is your partner paid?
Household details
Number of adults resident (over18) *
Number of children resident *
Financial statement
Please complete the information below for either monthly or weekly income
Is the information below *Monthly Weekly
Income
Wages/salary (net)
Partner's wage/salary (net)
Earnings from second job
Unemployment benefit
Income support
Child benefit
Working/child tax credits
Housing benefit/Universal Credit
Pension
Maintenance
Other (please specify)
TOTAL INCOME *
TOTAL SAVINGS *
Expenditure
Priority expenditure
Mortgage
Rent
Council tax
Electric
Gas
Oil/coal
Water
Non-priority expenditure
Loans (please give the amount and the date of final payment)
Hire purchase (please give the amount and the date of final payment)
Food
CCJs or fines (please give the amount and the date of final payment)
Credit cards
Telephone
Mobile phone
Medicines
Clothes
Catalogues
Fares - school/work
Car tax
Car insurance
Petrol
Car repairs
TV Licence
Satellite/cable
Internet
Alcohol and tobacco
Other (please specify)
TOTAL EXPENDITURE *
Totals
Total income *
Total expenditure *
Balance (+ or -) *
Payment proposal
I propose to pay *
Per week/per month *Week Month
Payment will commence on: *
To help us avoid abuse of our system, please enter the correct answer to the question below:

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Offer of repayment

Your employment details

Your partner's employment details

Household details

Financial statement

Expenditure

Totals

Payment proposal

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