Please read the document titled "Changing the way Central Bedfordshire Council supports Council Tax payers" and then give us your views by completing this form.

Q1	Which option do you feel the Council should take to fill the funding gap of £2.5 million each year? (Please tick one box)
	Increase Council Tax to all residents in Central Bedfordshire
	Cut some Council services to the value of £2.5 million
	Change who gets a reduction to their Council Tax and how much discount some people receive
	Other

Please specify other

Q2	How far do you agree or disagree with each of the following changes the Council is proposing to introduce as part of the new Local Council Tax scheme?
		Strongly agree	Agree	Neither agree nor disagree	Disagree	Strongly disagree	Don’t know
	A. Freeze the allowances and premiums at the current levels
	B. All working age claimants (except vulnerable groups) will pay a minimum of 25% of their Council Tax
	C. Abolish the second adult rebate
	D. Reduce the amount of support offered to people living with non-dependant adults
	E. Owners of second homes should pay full Council Tax on their second home
	F. Owners of unoccupied homes should pay full Council Tax
	G. Owners of empty homes undergoing repair should pay full Council Tax
	H. Mortgagees of repossessed homes will be required to pay full Council Tax
	I.  Owners of long term empty homes should be required to pay 150% of their Council Tax.
	K. Increase the earnings disregard by an additional £10 to support people who start work or increase their earnings

Q3	Please explain why you do not agree with any of the above proposals.

Q4	Central Bedfordshire Council is proposing to protect the following people from paying the minimum contribution of 25%.  How far do you agree or disagree that each of the following should be protected?
		Strongly agree	Agree	Neither agree nor disagree	Disagree	Strongly disagree	Don’t know
	A single person, their partner or children are disabled
	Single person with caring responsibilities (for elderly or disabled relatives for example)
	Couples who both have caring responsibilities (for elderly or disabled relatives for example)
	Single parents with children under the age of 5
	People claiming War Disablement or War Widow's Pension

Q5	Please explain why you do not agree with any of the above proposals.

About you

The following information will help us when considering your opinions and to make sure that we're getting the views of all members of the community. The answers will not be used to identify any individual. Our data protection statement is provided at the end of this form.

Q6	Are you responding as an individual or as an organisation? (Please tick one box)
	Individual
	Organisation (go to question 22)

Q7

What is your age?  (Years)

Q8	What is your sex? (Please tick one box)
	Male
	Female

Q9	Is your gender identity the same as the gender you were assigned to at birth? (Please tick one box)
	Yes
	No
	Prefer not to say

Q10	Do you, your partner or child(ren) have a long-standing illness, disability or infirmity? (Long-standing means anything that has troubled you over a period of time or that is likely to affect you over a period of time)  (Please tick one box)
	Yes		No

Q11	What is your Religion or belief? (Please tick one box)
	Buddhist
	Christian
	Hindu
	Jewish
	Muslim
	Sikh
	No religion
	Other

Please specify other

Q12	To which of these groups do you consider you belong? (Please tick one box)
	Bangladeshi	European
	Chinese	Other White background (please specify)
	Indian	White & Black Caribbean
	Pakistani	White & Black African
	Other Asian background (please specify)	White & Asian
	Caribbean	Other Mixed background (please specify)
	African	Arab
	Other Black background (please specify)	Gypsy/ Romany/ Irish Traveller/ Show People
	British	Other (please specify)
	Irish

Please specify other

Q13	What is your sexual orientation? (Please tick one box)
	Lesbian/ gay woman or man
	Bisexual
	Heterosexual
	Prefer not to say
	Other

Please specify other

Q14	Which of these activities best describes what you are doing at present? (Please tick one box)
	Permanent employee in full-time job (30 hours plus per week)
	Temporary employee in full-time job (30 hours plus per week)
	Permanent employee in part-time job (under 30 hours per week)
	Temporary employee in part-time job (under 30 hours per week)
	Self employed full or part-time
	On a government supported training programme (e.g. Modern Apprenticeship/ Training for Work)
	Full-time education at school, college or university
	Unemployed and available for work
	Permanently sick/disabled
	Wholly retired from work
	Looking after the home
	Doing something else

Please specify other

Q15	Please indicate the annual income in your household? (Please tick one box)
	Less than £10,000
	Between £10,000 and £20,000
	Between £20,000 and £30,000
	Over £30,000

Q16	Are you: (Please tick one box)
	Single
	Married or civil partnership
	Living with partner

Q17	Do any of the following live in your household? (Please tick all that apply)
	Adult (over 18) members of your family who are not dependant on you
	Adult (over 18) members of your family who are dependant on me
	No adult members of your family live with you

Q18	Do you have any children living with you?
		Yes		No (go to Q20)

Q19	How many children in the following age groups live with you? (Please write in how many children live with you in each age group)
	Under 5 years of age
	Aged between 5 and 11
	Aged 12 or older

Q20	Which of the following Council Tax Benefits, Discounts or Exemptions do you currently receive? (Please tick all that apply)
	Jobseekers Allowance, income related Employment and Support Allowance or Council Tax Benefit for low income
	Second Adult Rebate for Council Tax
	Non-Dependant Adult deductions for Council Tax
	Disability premiums
	Carers Allowance
	Discounts or Exemptions for second home, empty property or a repossessed home

Q21

What is your home postcode?

Q22	If you are responding as an organisation, what type of organisation are you?
	Town or Parish Council
	Voluntary Organisation or Charity
	Public Service
	Housing Association or Social Landlord
	Private Landlord
	Housing Developer
	Other

Please specify other

Thank you for taking the time to complete this form. Please click on the "Sumbit" button to send your answers.

Data Protection Act 1998. Please note that your personal details supplied on this form will be held and/ or computerised by Central Bedfordshire Council for the purpose of analysing the feedback to consultation on the Draft Local Council Tax Scheme. The information collected may be disclosed to officers and members of the Council and its’ partners involved in this consultation. Summarised information from the forms may be published, but no individual details will be disclosed under these circumstances. Your personal details will be safeguarded and will not be divulged to any other individuals or organisations for any other purposes. Information classification: Protected when complete