Ref no. (for office use only) Residential Property Tribunal Service
Regulation 49(2) of the Residential Property Tribunal Procedures and
Fees (England) Regulations 2011
Application for reduction or waiver of fees
It is important that you read the notes below carefully before you complete this form
This is the correct form to use if you want to ask the Residential Property Tribunal (“The Tribunal”) for a reduction or
waiver of fees under Regulation 49(2) of the Residential Property Tribunal Procedures and Fees (England) Regulations 2006.
Please send your completed application form to the appropriate Rent Assessment Panel. (See the Annex to this form for Panel addresses).
If you have any questions about how to fill in this form or the procedures the Tribunal will use, please call the Residential Property Tribunal Service on 0845 600 3178.
Address of property (including postcode):
Applicant address (including postcode):
Date of application to the Tribunal:
(1) Are you, or your partner , in receipt of any of the following benefits? YOU YOUR PARTNER
Income-Related Employment and Support Allowance
Income-based job seeker’s allowance
Working Tax credit where:
(a) either that credit includes a disability element or severe
disability element (or both) or it is combined with child tax credit and (b) the gross annual income used to calculate the Working Tax
Credit is ?16,190 or less
Guarantee Credit under the State Pensions Credit Act 2002
To allow us to assess your claim, we require confirmation, from the local office that deals with your benefit, of your entitlement to that benefit. To obtain this confirmation you can either take this form to that office for completion of section 3, or you can return the form to the Tribunal and we will send it to the relevant office for completion.
1Note : ‘Partner’ means (a) where the person is a member of a couple, the other member of that couple; or (b) where the person is polygamously married to two or more members of a household, any such member. ‘Couple’ means (a) a man and woman who are
married to each other and are members of the same household; (b) a man and woman who are not married to each other but are living
together as husband and wife; (c) two people of the same sex who are civil partners of each other and are members of the same
household; or (d) two people of the same sex who are not civil partners of each other but are living together as if they were civil
FORM RPT2 (05/11) 1
I agree that the local office dealing with my benefit may confirm to the Residential Property Tribunal that I was in
receipt of the following benefit on the date of an application to the Tribunal by me or my partner. This is to verify a
claim to waive fees payable for an application to the Tribunal.
Alternatively, the person in receipt of benefit can supply a current notice of entitlement to benefit. This will need to be
the original that, if posted, will be returned immediately by the Tribunal office.
Type of Benefit received:
Address of Office where benefit is claimed:
My name (IN CAPITALS):
My address (IN CAPITALS):
My National Insurance Number:
or Local Authority reference number (for Housing Benefit):
I certify that the above named benefit customer was in receipt of
(specify benefit) on (date of application to Tribunal), located on page 1 of this form
If benefit has ceased, please give last date of entitlement :
Section: Telephone number:
Office Stamp: Form to be returned after completion to:
FORM RPT2 (05/11) 2
NORTHERN RENT ASSESSMENT PANEL
Telephone: 0845 100 2614 or 0161 237 9491 First Floor, 5 New York Street,
Fax: 0161 237 3656 Manchester M1 4JB
This office covers the following Metropolitan districts: Barnsley, Bolton, Bradford, Bury, Calderdale, Doncaster,
Gateshead, Kirklees, Knowsley, Leeds, Liverpool, Manchester, Newcastle-upon-Tyne, Oldham, Rochdale,
Rotherham, St. Helens, Salford, Sefton, Sheffield, Stockport, Sunderland, Tameside, Trafford, Tyneside (North &
South), Wakefield, Wigan and Wirral.
It also covers the following unitary authorities: Hartlepool, Middlesborough, Redcar and Cleveland, Darlington, Halton, Blackburn with Darwen, Blackpool, Kingston-upon-Hull, East Riding of Yorkshire, Northeast Lincolnshire, North Lincolnshire, Stockton-on-Tees, Warrington and York.
It also covers the following Counties: Cheshire, Cumbria, Durham, Lancashire, and Lincolnshire.
MIDLAND RENT ASSESSMENT PANEL ndTelephone: 0845 100 2615 or 0121 236 7837 2 Floor, Louisa House, 92-93 Edward Street,
Fax: 0121 236 9337 Birmingham B1 2RA
This office covers the following Metropolitan districts: Birmingham, Coventry, Dudley, Sandwell, Solihull,
Walsall and Wolverhampton.
It also covers the following unitary authorities: Derby, Leicester, Rutland, Nottingham, Herefordshire, Telford and Wrekin and Stoke-on-Trent.
It also covers the following Counties: Derbyshire, Leicestershire, Nottinghamshire, Shropshire, Staffordshire, Warwickshire and Worcestershire.
EASTERN RENT ASSESSMENT PANEL
Telephone: 0845 100 2616 or 0122 384 1524 Unit C4, Quern House, Mill Court
Fax: 0122 384 3224 Great Shelford, Cambridge CB22 5LD
This office covers the following unitary authorities: Bracknell Forest, West Berkshire, Reading, Slough, Windsor
and Maidenhead, Wokingham, Luton, Peterborough, Milton Keynes, Southend-on-Sea and Thurrock.
It also covers the following Counties: Bedfordshire, Berkshire, Buckinghamshire, Cambridgeshire, Essex, Hertfordshire, Norfolk, Northamptonshire, Oxfordshire and Suffolk.
SOUTHERN RENT ASSESSMENT PANEL
stTelephone: 0845 100 2617 or 0124 377 9394 1 Floor, 1 Market Avenue,
Fax: 0124 377 9389 Chichester, PO19 1JU
This office covers the following unitary authorities: Bath and Northeast Somerset, Bristol, North Somerset,
South Gloucestershire, Bournemouth, Plymouth, Torbay, Poole, Swindon, Medway, Brighton and Hove, Portsmouth, Southampton and the Isle of Wight.
It also covers the following Counties: Cornwall and the Isles of Scilly, Devon, Dorset, East Sussex, Gloucestershire, Hampshire, Kent, Somerset, Surrey, West Sussex and Wiltshire.
LONDON RENT ASSESSMENT PANEL
Telephone: 020 7446 7700 10 Alfred Place,
London WC1E 7LR Fax: 020 7637 1250
This office covers all the London boroughs.
FORM RPT2 (05/11)