Application to license a house in multiple occupation from Stafford Borough Council

Step 2 of 4 Submit the application

Email address

Please provide your email address, so the licensing authority can let you know if your application has been successful or not.

Email address Confirm email address

Application form

Please attach the completed application form below.

Application form

Supporting documents

All documents are required, unless stated otherwise. Photos of documents are acceptable, as long as all the relevant information is clear. We'll only share these documents with the licensing authority.

Maximum size allowed per file is 10 MB.

We only allow the following file types : doc, docx, gif, jpeg, jpg, pdf, png, ppt, pptx, rtf, txt, xls, xlsx

What if I can't submit all of these documents?

You don't have to submit optional documents, but it may improve your chances of a successful application if you do.

What if I can't submit the documents digitally?

If you can't submit the documents digitally you can send copies by post instead. We'll give you the address and reference number to quote once you've paid the licence fee.

OK, I'll submit all the documents by post instead

Fire safety risk assessment
Landlords of HMO properties are required to comply with the the Regulatory Reform (Fire Safety) Order 2005 that requires a "suitable and sufficent" fire safety risk assessment for the purpose of identifying the general fire precautions they need to take. You must provide a copy of the latest assessment as part of this application. If you do not have an assessment, upload a blank document but you MUST arrange for this to be completed by a person competant to make that assessment.

Property plan
Please provide a plan for each floor of the property. Ideally this should be to scale, but where it is not, note the size of each bedroom, kitchen and living room in the property in square m, discounting the space taken up by any ensuite bathrooms. The plan should show the location of all smoke and heat detectors in the property, and record the position of fire rated (FD30s) fire doors to the property.

Electrical Installation Condition Report
Please provide the latest electrcial safety report for the property. This must not be more than five years old. If you do not have this document, upload a blank document, but you will need to ensure that you have the installation so checked to comply with the law, and risk a fine if you rent a property without providing this information.

Gas Safety Certificate (optional)
Where the property has gas fired heating or cooking facilities these are subject to the The Gas Safety (Installation and Use) Regulations 1998 and the installation must be inspected by a Gas Safe Registed engineer every year. Please provide the latest certifcate.

Declaration

I/we declare that the information contained in this application is correct to the best of my/our knowledge. I/we understand that I/we commit an offence if I/we supply any information to a local housing authority in connection with any of their functions under any of Parts 1 to 4 of the Housing Act 2004 that is false or misleading and which I/we know is false or misleading or am/are reckless as to whether it is false or misleading.
I/we declare that I/we have served a notice of this application on the persons detailed in section 18 of this application, who are the only persons known to me/us that are required to be informed that I/we have made this declaration.
The following additional declarations also apply if (and only if) you have indicated in section 2 of this application that this is a renewal application:
I/We declare that the house in respect of which a licence is sought under Part 2/Part 3 of the Housing Act 2004 is subject to a licence under that part at the time this application is made. I/We further declare that to the best of my/our knowledge either: (a) none of the information described in paragraph 2(c) to (g) of that Act and previously submitted to the authority has materially changed since that licence was granted; OR (b) the only material changes to that information are described in the preceding sections of this application.
How we use your personal information The information that you have provided on this form will be used by Stafford Borough Council, who are the data controller, for the processing of your application and providing you with a licence. We will only share your information with/ or on The Public Register, The Home Office, other Government agencies, Council departments and Enforcement agencies and the National Fraud Initiative when necessary or where the law otherwise requires or allows us to do so. For further information, please see www.staffordbc.gov.uk/privacynotices

Ticking this box indicates you have read and understood the above declaration

By continuing, you're giving the Cabinet Office permission to pass the information you're supplying to the relevant authority.

For more details on how your information is used please refer to the Government Digital Service privacy notice (opens in new tab) and the Stafford Borough Council privacy notice (opens in new tab).