Follow the steps to complete your application with ease.

1. Click ‘Get Form’ button to obtain the application form and open it in your preferred editor.
2. Input the full name of the severely mentally impaired person in the designated field.
3. Provide the address of the severely mentally impaired person to confirm residency.
4. Enter the Council Tax reference number, which can usually be found on council tax correspondence.
5. Indicate how many people aged 18 or over reside at the address, as this may affect eligibility.
6. Input a daytime phone number where you or the severely mentally impaired person can be reached.
7. From the provided list, select which benefit the person receives or qualifies for by ticking the appropriate boxes.
8. Indicate the date the benefit started, as this information is necessary for potential backdating of the claim.
9. Include any documentary evidence to support the entitlement claim alongside this form.
10. Provide the name and address of the doctor or consultant who will provide the required Doctor's Certificate.
11. Enter the date of birth of the severely mentally impaired person.
12. Sign the form to authorize the council to request the Doctor’s Certificate.
13. If applicable, provide your information if you are completing the form on behalf of the impaired person, including your relationship to them.
14. Complete the declaration stating that the provided information is accurate to the best of your knowledge.
15. Sign the declaration and include the date.
16. Provide a daytime phone number for any follow-up inquiries, ensuring that communication remains open.
17. Save changes, and choose to download, print, or share the completed form as needed before submitting.

Complete your application online today to ensure timely processing of your council tax discount.