First Name (required)

Surname (required)

Date of Birth (required)

National Insurance Number.

Property Address (required)

Garage address (where applicable)

Email Address (required)

Phone Number

Are you happy to receive documents via email?
YesNo

Contact Preference
PhoneEmailLetterFace to Face

Please state your occupation contract status
Please SelectSecureIntroductoryProhibited Conduct Standard ContractSupportedLicence

Your tenancy status
Please SelectAssuredAssured ShortholdDemotedEquitable

Preferred to be known by (required)

Reason for name change (required)
Please SelectMarriage (certificate needed)Divorce (certificate needed)Deed Poll (documentation needed)Personal Preference

Please state the reason for your name change request and where necessary, provide the relevant proofs.

Household Members (required)

Please confirm details on any other household members. (Full name, DOB, Gender, National Insurance Number, Relationship

Are you registered with HomeSeeker?
YesNo

If Yes please ensure you contact Torfaen Council in order for your details to be amended.

Are you registered with HomeSwapper?
YesNo

If Yes please login to your account to update your details.

Contract Holder Signature (required)