The Highland Council
Claim for Housing and Lodging Assistance

1.	I attach receipts in connection with my claim for Housing and Lodging Assistance

Dates of Claim:  From ………………………………………………	    To ………………………………	

Period of Claim: (e.g. weeks 8-12) …………………………………Amount of Claim (e.g. 4 weeks @ £75) ……………………..
	
2.	I request reimbursement of the sum of £ ……………………  	
(Note: Maximum allowance payable 26 weeks @ £75 (subject to the overall maximum of £6,500 for all Relocation and Removal Expenses).
3.	I confirm that should I leave the service of the Highland Council within the period of two years from the date of commencement of my employment with the Council, I shall refund to the Council;
	
	Within one year			- 		Full refund
	
	One year - 18 months		-		50% refund
	
	18 months - two years		-		25% refund

I hereby agree and consent to the making of one or more deductions from any salary or wages, as defined in Section 27 of the Employment Rights Act, 1996, due by the Council to me in respect of any refund due by me to the Council hereunder

Post ………………………………………..  	Service ……………………………………. 

Name (Print)............................................	Starting Date in Post………………………

Signature………………...........................                                  Date…………………………………………

THIS FORM SHOULD BE SUBMITTED TO:   recruitment.enquiries@highland.gov.uk
      
FOR OFFICE USE

Amount of Claim Authorised:  £

Authorisation by Head of Service        ……………………………………………..  				

					             Date	……………………………				

Date passed  for coding ………………………………. …………. 

Passed to (name) ……………………………………………………………..