Application for a determination as to whether a dwelling house is suitable for occupation by elderly persons

Published date21 March 2018
Subject MatterResidential Property (First-tier Tribunal) forms
First-tier Tribunal (Property Chamber)

First-tier Tribunal Property Chamber

(Residential Property)

Ref no. (for office use only)

Application for a determination as to whether a
dwelling house is suitable for occupation by elderly persons

Paragraph 11 to Schedule 5 of the Housing Act 1985 (as amended)

It is important that you read the notes below carefully before you complete this form

This is the correct form to use if you want to ask the Tribunal for a determination as to whether the exception from the ‘right to buy’ for occupation by elderly persons applies to your home. In order for the Tribunal to be able to make such a determination, this application must be received within 56 days of the date of service on you of your landlord’s notice (under section 124 Housing Act 1985).

A fee is payable for this application (see section 8 for Help with Fees).

Applications should be sent as a Microsoft Word document by email to the relevant regional tribunal address shown in the Annex to this form. You must also send by email a copy of the landlord’s notice to the appropriate regional Tribunal office. If you cannot access email or find someone to assist you in lodging your application by email, then a paper application will be acceptable although there may be a delay in dealing with this. Sending an application on paper will not be suitable in urgent cases.

You can now pay the the fee (if applicable) by an on-line banking payment or by cheque/postal order enclosed with the application form.

If you want to be sent online banking payment details by email, please tick this box

Please make sure a copy of the application is served on the other party/parties to the application. If you are unable to serve a copy on the other party/parties, please bring this to the tribunal’s attention in the covering email or if sending by post in a covering letter.

Please do not send any other documents. When further evidence is needed, you will be asked to send it in separately.

If you have any questions about how to fill in this form, the fee payable, or the procedures the Tribunal will use please contact the appropriate regional office.

If you are completing this form by hand please use BLOCK CAPITAL LETTERS.




Address (including postcode):

Address for correspondence (if different from above):





Email address
(if known):


Representative name and address, and other contact details: Where details of a representative have been given, all correspondence and communications will be with them until the Tribunal is notified that they are no longer acting for you.


Reference no. (if any)

Address (including postcode):




Email address:


  1. ADDRESS (including postcode) OF PROPERTY (if not already given)

  1. ADDRESS OF LANDLORD (This will be your Local Housing Authority or Housing Association)



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