Lewisham Council

Lewisham Council

Council tax - Application for discount/exemption due to severe mental impairment

Please complete this form if there is a person with a severe mental impairment living in the property. You will be required to provide evidence of your benefits and confirmation from your Doctor as part of this form. The form for your doctor to complete is available here . You can complete the form below and attach the confirmation from your doctor as a scanned image or send it to the Council separately.

Completing this form

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Please complete all of the questions marked with an asterisk.

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None of the information is retained if you do not submit the form. You will lose all the information if the form is not completed.

Property on which Council tax is paid


 
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Mentally impaired person's details

Please give the following details relating to the person who is severely mentally impaired

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Is this the liable person for council tax?
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Which of the following benefits does this person receive? Please tick all that apply.

We must see proof of these benefits and the date each benefit started to support your application.

Data protection and fraud prevention

The information given on this form may be held on computer to enable Lewisham Council to meet its statutory duties.

We may use the information you have provided to prevent and detect fraud.

We may also share this information with other councils or agencies that handle public funds.