Today's date (required)

Your Name (required)

Your Email (required)

Your address (required)

Phone Number (required)

I will be available to move from:

How many homes are involved in this exchange? (required)
123456

Please list details of everyone in the household who will be moving, starting with yourself as tenant.
Your name, sex and date of birth (required).
MaleFemale

Resident 2 - Name, sex, date of birth and relationship to tenant
N/AMaleFemale

Resident 3 - Name, sex, date of birth and relationship to tenant
N/AMaleFemale

Resident 4 - Name, sex, date of birth and relationship to tenant
N/AMaleFemale

Any further residents moving - please list name, sex, date of birth and relationship to tenant.

Details of present accommodation
Type of home (please select)
HouseFlatBungalow
Type of tenancy (please select)
AssuredSecureFixed-term
Number of bedrooms (required)

Any pets? (yes or no) YesNo

Please tell us:
Your landlord's name (required)

Their email address (required)

Their phone number (required)

Are you currently an employee of Greenfields Community Housing? (required)
YesNo

Are you currently receiving Housing Benefit or Universal Credit? (required)
Housing BenefitUniversal CreditNone

Is there anyone else, excluding those mentioned earlier, who lives with you now? (required)
YesNo
If yes, please give details

I would like to exchange with:

Their Name (required)

Their email (required)

Your reasons for requesting this mutual exchange

Important
Please be aware by exchanging properties you may lose your 'Right to Buy' and the conditions of your new tenancy may change. Please seek advice from your proposed new landlord. In addition, please note that we will only proceed to check your eligibility once you have ticked the declaration.
 
Declaration
I have inspected the property that I wish to move into and I am willing to accept it in its present condition. I understand that we can't move until we have received the written consent from our current landlords. I have read and understood the leaflet on exchanging homes. If you are joint tenants, you must both agree to the move. You will both be required to sign an agreement before a Mutual Exchange can take place.
 
I have read and I understand the statement above.
 
The information you provide will be processed to check your eligibility for “Mutual exchange”. For further information regarding how we may use, store, process and share your personal information, please see Our Privacy Policy
 
I confirm that the information supplied is true and complete to the best of my knowledge.