Housing Benefit and Council Tax Support Certificate of Earnings

This form will ask you to provide

  • your details including National Insurance number
  • your Housing Benefit or Council Tax Support reference number (if known)
  • employer's full name or company name
  • employer's address and phone number

Your employer will need to complete this form or provide a proof letter stating:

  • your employment start date
  • hours you normally work per week
  • your normal basic hourly rate
  • date of their last pay increase
  • how often you are paid (weekly, fortnightly etc) and how you are paid (cash, cheque, bacs etc)
  • for the current financial year (please state from and to dates this period covers) to date the gross pay, tax and net National Insurance
  • your earnings for the last five weeks if paid weekly, three fortnightly payments, or two monthly/four weekly payments. Figures must include bonuses, overtime and commission. Actual earnings (including any SSP or SMP paid)
    • date paid
    • gross pay
    • income tax deductions
    • employee's National Insurance contributions
    • employee's contribution to pension scheme
    • SSP or SMP
    • hours worked
    • take home pay (net)
    • if the earnings for this period are typical, if not are they higher or lower
  • if you have been employed for less than 5 weeks, we will need your estimated earnings
    • gross pay
    • income tax deductions
    • employee's National Insurance contributions
    • employee's contribution to pension scheme
    • hours worked
    • take home pay (net)

This information can be provided by

  • the employer completing this form
  • uploading the employer proof letter to this form

You can upload the letter to this form now or you can send it later but we won't process your application until we have received your proof. You must send your proof within the next two weeks otherwise we will cancel your application and you will need to reapply, if you wish to do so.

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Privacy Statement

Dover District Council is a Data Controller under GDPR.  In submitting this form we will collect and process your personal data.  For information about your rights and how the Council uses your data, please view our Corporate and relevant service privacy notice which can be found on our Privacy Page.

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