Download this form if you want to print it out and fill it in by hand.
Alternatively, apply for extra help with removal costs online.
Who can apply
To apply, you must receive Housing Benefit or Housing Costs in your Universal Credit.
What you'll need to apply
You must provide:
- three quotes from the van hire or removal companies. These quotes must include the company bank sort code, account number and account holders name and correspondence addresses and contact telephone number. We cannot accept online comparison quotes
- up to date proof of all capital held in all bank accounts for you and your partner, for the previous 30 days. You might need to ask your bank for a print out of your accounts on the day you hand in this form.