Because this claim form needs to be authenticated by signature for the claim to be considered it is not possible to submit this form electronically.
This form may be completed electronically and when submitted will create a printable PDF version of the form for you to sign.
To print this form you must allow popups on this site.
Alternatively you may wish to complete this form by hand. In which case please choose the PDF version of this claim form.
The Council uses your personal information in order to administer and enforce Council Tax under the Local Government Finance Act 1992. This authority has a duty to protect public funds it administers, and may use information you have provided on this form for the prevention and detection of fraud. It may also share this information with other bodies responsible for auditing or administering public funds for these purposes. For further information, see www.harlow.gov.uk/dme on Harlow Council’s website.
The Council will also use the information for the purpose of performing any of its statutory enforcement duties and any disclosures required by law.