Please complete both pages of this form and return it to: the Council Tax
Office, PO Box 32, Bolton, BL1 1RX.
About the person who is responsible for paying the Council Tax
Full name:
Address:
……………………………………………………
……………………………………………………
……………………………………………………
Daytime phone number: ……………………………………………………
Would you like your bill by email? Yes No
Email address
Council Tax account reference
……………………………………………………
How many people aged 18 or over normally live at this address:
Will anyone else in the property become 18 in the next 2 years? Yes No
If yes, please give their names and date of bir th: ………………………………………………….
…………………………………………………..
About student nurses and midwives
Is the student training to be a midwife or health visitor? Yes
Please provide written confirmation from the Royal College of Nursing
The spouses and dependents of students from abroad
Is the person living in the UK with someone from abroad who is a full time student? Yes No
Does the person’s visa state they are prohibited from taking paid work or recourse to public funds? Yes No
No
Please provide a copy of the person’s passport which shows their visa.
Foreign Language Assistants
Is the student registered with Central Bureau for
Educational Visits and Exchanges? Yes No
Do they work as a foreign language assistant at a school or other educational institution in Great Britain?
Yes No
Please provide proof of registration with Central Bureau for Educational Visits and Exchanges

List below the names of all students who live in the property
First name Last name Name of university or college and registration number
Course Start Date Course End
Date
To award the discount to your address we need a student certificate for each of the students except if they attend Bolton, Salford or Manchester
Metropolitan University. If they attend one of these, you must provide their student registration number above.
Declaration
I declare the information that I have given is correct and complete to the best of my knowledge. I understand the council may make enquiries to verify the information I have given. If I give information which is incorrect or incomplete, you may take action against me, which may include court action. I will notify you immediately if my circumstances change which will affect the amount of council tax charged.
Signed ………………………………………………… Date……………………………………..
Data Protection : Any information you give will be used to decide your council tax liability. We may share, or obtain information about you with other sections of the council, other councils, data protection agencies and government agencies to make sure the information is accurate, prevent and detect fraud and to protect public funds. We will not give information about you to anyone else, or use information about you for other purposes, unless the law allows us to.