Leasehold occupancy audit

Leasehold Occupancy Audit

Your name *

Your email *

Your phone number *

Your date of birth *

Your National Insurance number This helps us with our security checks.

What is your Irwell Valley Homes property address? *

Do you live at this property? If you answer No, you will be redirected to an alternative form

Yes

Do you have any support needs or disabilities? *

Yes

Please provide more details of any support needs or disabilities. * Write 'None' if you do not have any support needs or disabilities.

Are you able to escape from the building unassisted and without using the lift in the event of a fire? *

Yes

Are there any pets at the property?

If yes, please tell us what type of pets you have and how many you have of each.

Does anyone else live in the property? If answering yes, please complete the details for occupant 2, 3, 4 etc as required.

Yes

Occupant 2: Name

Their relationship to you e.g. wife, son.

Occupant 2: Date of birth

Occupant 2: Phone number

Occupant 2: Email address

Occupant 2: Can they escape from the building unassisted and without using a lift?

Yes

Occupant 2: Do they have any support needs or disabilities?

Yes

Occupant 2: Please detail any support needs or disabilities they have.

Does anyone else live in the property?

Yes

Occupant 3: Name

Their relationship to you

Occupant 3: Date of birth

Occupant 3: Phone number

Occupant 3: Email address

Occupant 3: Can they escape from the building unassisted and without using a lift?

Yes

Occupant 3: Do they have any support needs or disabilities?

Yes

Occupant 3: Please detail any support needs or disabilities they have

Does anyone else live in the property?

Yes

Occupant 4: Name

Their relationship to you

Occupant 4: Date of birth

Occupant 4: Phone number

Occupant 4: Email address

Occupant 4: Can they escape from the building unassisted and without using a lift?

Yes

Occupant 4: Do they have any support needs or disabilities?

Yes

Occupant 4: Please detail any support needs or disabilities they have

Does anyone else live in the property?

Yes

Occupant 5: Name

Their relationship to you

Occupant 5: Date of birth

Occupant 5: Phone number

Occupant 5: Email address

Occupant 5: Can they escape from the building unassisted and without using a lift?

Yes

Occupant 5: Do they have any support needs or disabilities?

Yes

Occupant 5: Please detail any support needs or disabilities they have

Does anyone else live in the property?

Yes

Occupant 6: Name

Their relationship to you

Occupant 6: Date of birth

Occupant 6: Phone number

Occupant 6: Email address

Occupant 6: Can they escape from the building unassisted and without using a lift?

Yes

Occupant 6: Do they have any support needs or disabilities?

Yes

Occupant 6: Please detail any support needs or disabilities they have

Do you have any further information you wish to supply? Include anything else that you think is relevant about who lives in the property and their circumstances.

As you have said you don't live at the Irwell Valley Homes property, what is your correspondence address? *

Do you use a managing agent to manage your property?

Yes

What is the company name?

What is the company phone number?

What is the company email address?

Who is the main contact person?

Are there any pets living at the property? *

Yes

If yes, please detail the type of pet and how many there are of each.

Please now provide the details of the people living in the home. Occupant One: Name

What is their relationship to you e.g. tenant.

Occupant One: Date of birth

Occupant One: Phone number

Occupant One: Email address

Occupant One: Can they escape from the building unassisted and without using a lift?

Yes

Occupant One: Do they have any support needs or disabilities?

Yes

Occupant One: Please detail any support needs or disabilities they have

Does anyone else live in the property?

Yes

Occupant Two: Name

What is their relationship to you? e.g. tenant.

Occupant Two: Date of birth

Occupant Two: Phone number

Occupant Two: Email address

Occupant Two: Can they escape from the building unassisted and without using a lift?

Yes

Occupant Two: Do they have any support needs or disabilities?

Yes

Occupant Two: Please detail any support needs or disabilities they have.

Does anyone else live in the property?

Yes

Occupant Three: Name

What is their relationship to you? e.g. tenant.

Occupant Three: Date of birth

Occupant Three: Phone number

Occupant Three: Email address

Occupant Three: Can they escape from the building unassisted and without using a lift?

Yes

Occupant Three: Do they have any support needs or disabilities?

Yes

Occupant Three: Please detail any support needs or disabilities they have.

Does anyone else live in the property?

Yes

Occupant Four: Name

What is their relationship to you? e.g. tenant.

Occupant Four: Date of birth

Occupant Four: Phone number

Occupant Four: Email address

Occupant Four: Can they escape from the building unassisted and without using a lift?

Yes

Occupant Four: Do they have any support needs or disabilities?

Yes

Occupant Four: Please detail any support needs or disabilities they have.

Does anyone else live in the property?

Yes

Occupant Five: Name

What is their relationship to you? e.g. tenant.

Occupant Five: Date of birth

Occupant Five: Phone number

Occupant Five: Email address

Occupant Five: Can they escape from the building unassisted and without using a lift?

Yes

Occupant Five: Do they have any support needs or disabilities?

Yes

Occupant Five: Please detail any support needs or disabilities they have.

Please use this space to provide any further information you wish to supply.

Consent for storing submitted data *

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