The Wokingham Household Support Fund is funded by the Department for Work and Pensions and administered by Wokingham Borough Council. The fund is designed to provide short-term financial support to households who are struggling to afford household essentials.
These households will need help with the cost of food, energy, water bills and other essentials. The fund is being distributed by Citizens Advice Wokingham and Wokingham United Charities assisting Wokingham Borough Council as part of the Hardship Alliance.
Please be aware that this is a limited fund to assist with household essentials - this fund is operating June to 30th September 2022. Applications relate to the physical household as much as to your families living arrangements. Therefore, there can only be one application per household. We expect another round will open from October 2022.
Consent to Privacy Policy* Consent to hold data within our case management system and share approved applications with Wokingham United Charities in order to disperse funds and Wokingham Borough Council who manage the Household Support Fund for reporting purposes.
Tick to accept and proceed
Information about you and your household.... Your Full Name*
Prefix
Dr Miss Mr Mrs Ms Prof. Rev.
First
Last
Your Date of Birth* Your Gender* Please Select Male Female Prefer a different term Prefer not to say
Your Address*
Have You or Anybody in Your Household Applied to the Household Support Fund since June 2022?* We can only accept one application form per household unless in a House of Multiple Occupation (HMO) and unrelated. If you're in a HMO and unrelated to another applicant, please email admin@cawokingham.org.uk
How Can We Contact You?* It is important that we are able to quickly and easily contact you to avoid any delays to your application. If you are able to communicate by email please tick this box along with any other relevant methods
You have chosen not to be contacted by Email. If you have an email address it would help expedite the processing of your claim so please could you consider providing it. It will be held in the strictest confidence and not used for any other purpose
Your Email Address* By providing your email address you are consenting to be contacted by email.
Can We Leave a Voicemail if Necessary?* Can We Send a SMS Text if Necessary?* Please note that if we call you the call will come from 0808 278 7958. We will call a maximum of two times on two different days, please answer the phone to ensure we can process your application as soon as possible.
Can We Also Send You a Letter?* Only if needed.
Do any of the following apply? Your Household* Please select the best option that describes your household. Your household is your family members that live with you.
Please Select... Single Person Single Person with Dependent Children Single Person with non Dependent Children Couple Couple with Dependent Children Couple with Non Dependent Children Other Adults and Non Dependent Children
Age(s) of Children* Please provide the age of each child, aged 18 or under, that lives in your household. Use the + symbol to add more rows
Name(s) of Other Adults in Your Household* Please provide the names of each adult (over 18) in your Household. Use the + symbol to add more rows. If there are no other adults please write none
Information about the amount of money you have to live on each month.... Is Your Household In Receipt of Means-Tested Benefits?* Means tested benefits are those that you are entitled to if you are on a low income, such as Universal Credit
Is Your Household in Receipt of Universal Credit?* Do You Have an Online Journal?* What Legacy Benefits is Your Household in Receipt Of?* These are benefits that pre-date Universal Credit and that you may still be in receipt of
What is the total amount of income your household receives each month?* Household income is defined as all income coming into the household from adults aged 18 or over from earnings, employment and self employment, benefits, pensions and income from savings and investments. Please do not include income from health related benefits such as DLA, PIP and Attendance Allowance. Please also do not include earnings from any young person who is still in full time education (school, sixth form or college)
If your household includes 2 or more adults please give the total income for your whole household.
Please Select... £799 or less £800 - £999 £1,000 - £1,300 £1,301 - £1,499 £1,500 - £1,999 £2,000 - £2,499 £2,500 or more
Do you have any savings and capital?* Savings and capital is defined as money you have in bank accounts, in any type of investment (including ISAs), and in ownership of valuable assets such as other property. Please do not include the home you live in or other assets you need day to day such as cars you need for work or childcare.
What essential support do you need.... An award from the Household Support Fund is capped at a maximum amount. If your application is approved we will agree with you how your award will be split between the different areas of need you have explained below. You will not get more support because you have listed needs in every category.
I/We Need Help With Food Costs*
Please Select... Yes No
The vouchers have to be assigned to a particular supermarket, which one would you choose?* Asda Morrisons Tesco Aldi
I/We Need Help to Pay Household Energy and/or Water Bills* Household energy is Gas, Electric, Oil and Solid fuels
Please Select... Yes: I have pre-payment meters Yes: I don’t have pre-payment meters No
I/We Need Help With Housing Costs or other wider essentials* Exceptional cases of genuine household emergency are only likely to be cases of impending eviction due to rent arrears, where all other options have been exhausted. This cannot be used to pay for mortgage arrears
Please Select... Yes (please explain in detail below) No
I/We Need Help to Pay for Housing Costs or Something Else That I/We Consider Essential* Please explain what else it is you need help with or what your housing emergency situation is
Of all the Support Needs Listed Above Which do You Need the Most?* Please Tell Us The Main Reason for Needing Support from the Household Support Fund* Please Select... Increased bills and cost of living Loss of benefits Low income My/Our income from earnings has dropped Reduced hours at work Keeping up with debt repayments Sickness or ill health Relationship Breakdown Something else
Please Explain What Else*
After receiving this grant, would you like advice from us on any of the issues you're dealing with?* Please tick the areas you would like advice in, and provide any further details of your issue*
If your application is approved how can we provide your grant.... We will need to split your grant award based on the help areas you highlighted above (Food, Fuel, Housing or Other Essentials)* Please tell us whether Food Vouchers, Fuel Vouchers or other Vouchers should make-up the majority of the support you receive - so that we can try and prioritise this.
Evidence to support your application.... It is very important to provide us with the evidence we have asked for below . If you are unable to this will delay your application as we will need to ask for it via post, via email or in person. We cannot make an award without the evidence .must show your current address please. Photographs or scans of paper based evidence, such as letters, should be dated within the last 6 months and must show your name and address please.
Agreement* Obtain Proof of You Universal Credit - Online Journal Make sure any screen shot includes where it shows your name and address
Obtain Proof of You Universal Credit - Telephone Claim Make sure the photograph includes your name and address as well as the payment
Upload Proof of Your Universal Credit* Upload Proof of Your ID and Wokingham Borough Address* Please provide a photograph or scanned image of official documents proving your ID and/or address. For example, a passport, driver's license, council tax bill, utility bill, bank statement or letter from DWP
Please email copies to HSF@cawokingham.org.uk. If we do not receive this within 5 working days of your application we will contact you to help with providing evidence.
Upload Proof of Your Means Tested Benefits* Please provide a photograph or scanned image of a benefit award letter from DWP, HMRC or local council that is no more than 6 months old. If you only have an older letter please upload it but ALSO upload a bank statement showing payments of this benefit(s) in the last month
Upload your Latest Bank Statement or Screen Shots of Online Banking Transactions* This must cover a full calendar month and be a period within the last 3 months. Screen shots of online banking must show your name as well as transactions. Please provide multiple screen shots if required. If you have more than one bank account please upload the latest bank statement for each account
Completion and Declaration.... Did Someone Help You to Fill in This Form?* This could be a friend, a family member, or a member of an organisation. Please provide their details below.
Their Name*
Prefix
Dr Miss Mr Mrs Ms Prof. Rev.
First
Last
Consent to contact Please tick here if you give your consent for us to contact this person and discuss the application on your behalf.
I consent.
Would You Like Us to Send a Copy of this Application to You? Please be aware that any email we send will come from hsf@cawokingham.org.uk - this may end up in your Junk/spam folder so please check
Declaration - Please remember it will take at least a week to get through your application, possibly longer depending on the volume. We will contact every single person that applies.* I confirm that the information I have provided in this application is accurate and a true representation of my/our household. I agree to Citizens Advice contacting me via the method(s) I have provided, and also contacting anybody who I have stated helped me to complete this form, where necessary to assist in processing the application. I understand that where Wokingham Borough Council suspects that fraud may have occurred it will investigate the matter as appropriate and this may lead to criminal proceedings. If I attempt to claim an award from the Household Support Fund by making a false declaration or providing false evidence I may have committed an offence under the Theft Act 1968.
I confirm.
