Your Name * Daytime contact telephone number * E-mail * Address of property for which you wish to claim council tax exemption * Postcode * Council Tax Reference Number (if known) In terms of schedule 11 of the Local Government Finance Act 1992, and the Council Tax (Exempt Dwellings) Scotland Order 1997 (as amended), a dwelling may be exempt from Council Tax. This application is for a dwelling which has become unoccupied because the resident is providing or receiving personal care, and carries an unlimited period of exemption while the qualifying conditions are met. Section 1 - Exemption details All of the following questions must be completed before your application can be accepted. 1. Exempt period from to Reason(s) why you are providing or receiving personal care 2. Please indicate the reason(s) why you are providing or receiving personal care by checking one or more of the following * Old Age Disablement Illness Past or present alcohol dependence Past or present drug dependence Past or present mental disorder How to complete the remainder of this application If you are providing care to another person go to section 2 If you are receiving care from a relative go to section 3 If you are receiving care from a hospital / residential home go to section 4 Section 2 - Please complete if you are providing care 1. Name and address of person who is being cared for 2. Expected date at which you will stop providing care 3. Name of person providing care 4. Please enclose a letter from your Doctor as confirmation that you are required to provide care, or a letter from DWP confirming you are in receipt of Carer’s Allowance. Section 3 - Please complete if you are receiving care from a relative 1. Name of person receiving care 2. Address at which care is being provided 3. Name of relative providing care 4. Expected date you will return home 5. Please enclose a letter from your Doctor as confirmation that you are required to receive care from a relative. Section 4 - Receiving long term care in a hospital or a home. if you are receiving long term care in a hospital or home please provide a letter on headed paper from the hospital or residential home confirming the following:Name of person receiving careDate of admissionExpected discharge date (if known)Details of care receivedThe application will not be accepted unless a letter is provided. I declare that the information in this form is true and complete. I authorise Argyll & Bute Council to verify the details. If exempt status no longer applies to this property I undertake to notify Argyll & Bute Council within 21 days of this occurring and understand that failure to do so may result in a fine of £50 and £200 on repeated failure to do so. Submitted by * Name The information you have supplied on this form will be used for the purpose for which you have provided it, and appropriate measures are in place to protect your personal data. A full privacy notice, which provides information about your rights under current data protection legislation and details about what will happen to your personal data can be found here:Privacy Notice - Council tax Leave this field blank CAPTCHAThis question is to test whether you are a human visitor and to prevent automated spam submissions.
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