Request for Business Support Advice

Crisis Resilience Fund – CRISIS PAYMENTS

If you are experiencing financial difficulty you can apply for support through the Crisis and Resilience Fund (CRF). Our aim is to help you stabilise your situation, strengthen your financial resilience and access the right support at the right time.

The CRF is intended to provide timely and effective support to residents who experience a financial shock and find themselves in financial crisis. A financial shock is a sudden, unexpected expense or drop in income, that can place pressure on their budget and wellbeing.

CRF also aims to strengthen long‑term financial resilience and reduce the need for crisis support in the future.

This includes:

Crisis support to manage short‑term emergencies
Support for households that rely on heating oil for their home heating
Support with essential household items, including white goods and beds
Support with housing costs
Access to services delivered in partnership with local voluntary, community and faith organisations to help households improve their financial security and resilience

All awards are discretionary, there is no automatic right to receive a payment.

Every application is assessed, including your household income, essential expenditure, accessible capital, your needs and underlying issues. Support is offered when a household does not have sufficient resources to cope with the immediate crisis without incurring unmanageable debt or going without essentials such as food.

Please upload all proofs during the claim process to avoid any delays caused by information having to be requested from you.

Section 1: Your details (The applicant)

Your Name(Required)

Title First Name Middle Name Last Name

Your date of birth(Required)

Your National Insurance (NI) Number(Required)

You will find this on your National Insurance card, benefit letter, payslip or P60. For example, AB123456C. Do not leave any gaps when entering your NI number.

Your Address:(Required)

Street Address Address Line 2 Town / Postcode

Your preferred telephone number:(Required)

Email address:(Required)

Is someone else helping you with this form?(Required)

Yes

No

Their Name(Required)

First name Middle name Last name

Their Address:(Required)

Street Address Address Line 2 Town / Postcode

Their preferred telephone number:

Their relationship to you:

Please outline how you are paying for utilities and food.(Required)

Has there been a death in the household in the last 12 months?(Required)

Yes

No

Do you have any savings or property here or abroad?(Required)

Yes

No

Please provide evidence – e.g. banks statements(Required)

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB, Max. files: 4.

Are you receiving financial support from any other fund or have you applied to any other hardship funds?(Required)

Yes

No

Please tell us which fund:(Required)

What are the current circumstances which are causing you hardship?(Required)

How long do you expect these circumstances to continue?(Required)

What have you done to improve this situation?(Required)

Please provide any additional information you think will support your claim.

Section 3: statement of income and expenditure

Does anyone live with you?(Required)

Yes

No

Please provide details of all people living with you:(Required)

Please click on (+) button to add more members

Name

Date of Birth

Relationship to you

Detail of all incomes:(Required)

Please provide details of all income for you and your partner if you have one:

Please click on (+) button to add more entries

Type of income

You: (£ per week)

Your partner: (£ per week)

Please upload proof of all income listed above

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB, Max. files: 10.

Detail of all expenditures(Required)

Please provide details of all expenditure for you and your partner combined if you have one:

Please click on (+) button to add more entries

Type of expenditure

Amount per week

Detail of any other expenditures not covered above:

Please provide details of all expenditure for you and your partner combined if you have one:

Please click on (+) button to add more entries

Type of Expenditure

Amount per week

Total expenditure (per week):(Required)

Section 4: Payment

FOOD

Supermarket Vouchers

ESSENTIAL ITEMS

Supermarket Vouchers

FURNITURE OR APPLIANCES

Please state the items that you are applying for and state the reason for this

ESSENTIAL TRANSPORT

Please state the reason for this and amount you wish to claim

DEBT OR BILLS

Please confirm details (and provide proof) of the bill that you need help with and tell us why?

Proof of the bills that you need help with

Max. file size: 64 MB.

UTILITIES: WATER, GAS, ELECTRICITY, FUEL, OR OTHER ESSENTIAL SERVICES

Please confirm details (and provide proof) of the bill that you need help with and tell us why?

Proof of the utilities that you need help with

Max. file size: 64 MB.

OTHER

Please complete if you need support with anything else that is not listed. Please provide proofs as necessary.

Other

Please upload any documents that support the reason provided above

Max. file size: 64 MB.

Section 5: Declaration

I declare that the information I have given on this form is true and correct. I understand that I may be prosecuted if I try to get a Crisis Resilience Fund Housing Payment and/or Council Tax Support Exceptional Hardship Payment dishonestly. I authorise Hyndburn Borough Council to make enquiries necessary to verify the details I have given on this form.

How would you like to present your signature?(Required)

Sign electronically

Upload my signature as a file

Signature(Required)
A signature can be added in this box by using a mouse for a PC or by using a finger or suitable pen on a touch screen OR an electronic signature should be uploaded as a file below .

Signature Upload(Required)
Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.

This field is hidden when viewing the form

Date

Section 4a: Declaration to be signed if you have completed this form on behalf of someone else:

I declare that the information I have given on this form is true and correct. I understand that I may be prosecuted if I try to get a Crisis and Resilience Fund payment dishonestly. I authorise Hyndburn Borough Council to make enquiries necessary to verify the details I have given on this form.

I confirm that I have been given permission by the applicant to complete this form on their behalf. I confirm that I understand that I may not be entitled to any information about this applicant or this application as a result of completing this form. I authorise Hyndburn Borough Council to make enquiries necessary to verify the details I have given on this form.

How would you like to present your signature?(Required)

Sign electronically

Upload my signature as a file

Signature(Required)
A signature can be added in the box above using a mouse for a PC or by using a finger or suitable pen on a touch screen OR an electronic signature should be uploaded as a file below .

Signature Upload(Required)
Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.

This field is hidden when viewing the form

Date

BRCC - Crisis Resilience Fund - Crisis Payment - Hyndburn Borough Council - Live

Section 1: Your details (The applicant)

Section 2: about your current circumstances

Section 3: statement of income and expenditure

Section 4: Payment

Section 5: Declaration

Section 4a: Declaration to be signed if you have completed this form on behalf of someone else: