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Confidential monitoring

You do not need to fill in this part of the form.

We ask for this information to make sure we provide a fair and equal service to all our customers.

If English is not your main language, which language would you like us to...

Is there anyone who relies on you...

Please answer the following so we can direct our support to those who may be affected by the Welfare Reforms.

Data protection

The information you supply on this form will be sent to Six Town Housing. It will only be used to process your request for information or services described on this page. Any details you supply will be treated as confidential and will only be used in direct relation to work needed to carry out your request.