To help us make an application, please let us know which of the following best describes you.

Your details

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All fields marked with (*) are mandatory

01 - Your details
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Your details

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Benefits & tax credits

Please select the benefits and/or tax credits you, or someone living with you, receives.

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This can be a bank statement or copy of your benefits award, and can be a photo or a screenshot from a phone. (We only need to see the benefit being paid into your account, nothing else)

Select file

This can be a bank statement or copy of your benefits award, and can be a photo or a screenshot from a phone. (We only need to see the benefit being paid into your account, nothing else)

Select file

This can be a bank statement or copy of your benefits award, and can be a photo or a screenshot from a phone. (We only need to see the benefit being paid into your account, nothing else)

Select file

This can be a bank statement or copy of your benefits award, and can be a photo or a screenshot from a phone. (We only need to see the benefit being paid into your account, nothing else)

Select file

This can be a bank statement or copy of your benefits award, and can be a photo or a screenshot from a phone. (We only need to see the benefit being paid into your account, nothing else)

Select file

This can be a bank statement or copy of your benefits award, and can be a photo or a screenshot from a phone. (We only need to see the benefit being paid into your account, nothing else)

Select file

This can be a bank statement or copy of your benefits award, and can be a photo or a screenshot from a phone. (We only need to see the benefit being paid into your account, nothing else)

Select file

This can be a bank statement or copy of your benefits award, and can be a photo or a screenshot from a phone. (We only need to see the benefit being paid into your account, nothing else)

Provide details of the person who receives one or more of the benefits or tax credits.

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Medical conditions

Provide details of the person in your household with a medical condition needing extra water use if it’s not yourself
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Large families

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This can be a photo or screen shot of a bank statement showing the benefit amount (we don’t need to see any other information)

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Declaration

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Confirmation check