EMPTY DWELLING MANAGEMENT QUESTIONNAIRE

Please read this questionnaire carefully, answer all the questions and give as much
information as possible. Please return the completed form and any additional
information to:

The Empty Homes Officer

[Council name and address]

PART 1: WHY IS THE PROPERTY EMPTY?

Please read questions a) to k) below and then move to the following section.

a) Was the property occupied by you as your main or primary residence?

If so is now unoccupied because:
i) you are temporarily resident elsewhere?
ii) you are resident elsewhere to receive personal care due to old age,
disablement, illness, past or present alcohol or drug dependence, or past
present mental disorder?
iii) you are absent to provide, or better provide, personal care for a person
who requires such care due to old age, disablement, illness, past or
present alcohol or drug dependence, or past pr present mental disorder?
iv) you are a serving member of the armed forces and are absent from the
dwelling as a result of this service?
b) Is the property in question a second or holiday home?
c) Are you genuinely actively trying to sell or let the property?
d) Is the property comprised in an agricultural holding within the meaning on the
Agricultural Holdings Act 1986 or a farm business tenancy within the meaning of
the Agricultural Tenancies Act1995?
e) Is the property usually occupied by someone employed by you in connection
with his duties under the terms of his contract?
f) Is the property available for occupation by a minister of religion as a residence
from which to perform his duties?
g) Is the property subject to a court order freezing your property?
h) Is the property prevented from being occupied as a result of a criminal
investigation or proceedings?
i) Is the property mortgaged and the mortgagees (lenders) have taken possession
of the dwelling?
j) Has the person who was the relevant proprietor of it died and six months have
not elapsed since the grant of representation was obtained in respect if such
person?
k) Is the property empty for any other reason?
l) Is there a planning application in progress?

If you can answer yes to any of the questions a) to k) above, please provide as much
information as you can about the circumstances in which the property is empty in the
space below. Please also send us any documentary evidence that you have in
support of the information you provide.
PART 2: WILL THE PROPERTY BE OCCUPIED SOON?

a) Are you currently taking any steps to bring the property back into occupation?
b) Do you plan to take any steps to bring the property back into occupation?

If you can answer yes to either of the above questions a) or b) please provide as
much information as you can about the steps you are taking, or are planning to take,
to bring the property back into occupation in the space below. Any documentary
evidence that you have in support of the information you provide should be sent to us
as well.

Thank you for completing this questionnaire. Now please return it to the address at
the top of the first page.

Thank you very much for your co-operation.