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JSP 464 - Ministry of Defence

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IN CONFIDENCE WHEN COMPLETED<br />

PROPORTIONALITY EXERCISE ASSESSMENT FORM<br />

This form is used to establish a Service family’s continued occupancy <strong>of</strong> SFA/SSFA after<br />

entitlement ceases. The Licensee and/or spouse should provide as much information as<br />

possible at the earliest opportunity to assist the HASC and Local Service Commander in<br />

establishing an agreed notice to vacate (NTV).<br />

For Housing Provider use only:<br />

Licensee Name<br />

SFA / SSFA Address<br />

Date NTV expires<br />

------------------------<br />

Part 1: TO BE COMPLETED BY LICENSEE OR OCCUPANT<br />

(Complete all sections; if section is not applicable, insert ‘N/A’)<br />

A. PERSONAL / CONTACT DETAILS<br />

Mil Tel No<br />

Home Tel No<br />

Mobile<br />

Email<br />

OCCUPANTS<br />

Name Relationship Date <strong>of</strong> Birth (under 18)<br />

B. FUTURE HOUSING INTENTIONS<br />

The Licensee should provide as much detail as possible <strong>of</strong> the family’s future housing<br />

intentions. Answer all questions; where the question does not apply, answer ‘N/A’.<br />

For cases <strong>of</strong> estrangement only<br />

If you have children, will the children live<br />

with you or your spouse?<br />

As at 13 Jul 12 3G - 1<br />

LICENSEE SPOUSE<br />

In cases <strong>of</strong> estrangement, the remainder <strong>of</strong> this form is to be completed by the<br />

occupant who remains in SFA/SSFA.<br />

For moves to another duty station<br />

Do you intend to apply for SFA?<br />

Do you intend to apply f<br />

………..or SLA?<br />

Yes / No

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