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Challenge for Wolverhampton

iCM Form
  1. Label
    1. Do you currently hold a Blue Badge, or have you held a Blue Badge before? *
    2. If yes, you have had a Blue bage before
  2. Proof of address, dates within the last 12 months.
    1. It is essential that you refer to Guidance notes - page 1, section 1a We need to check that you are a resident in this local authority area before we can process your application. Please select one of the following options and upload the documation where relevant.
  3. I give consent to the local authority to check my personal details on the local authories Council Tax database so that I do not need to upload proof of my address.
  4. I give consent to the local authority to check my personal details on the local authories Council Tax database so that I do not need to upload proof of my address. *
  5. OR
    1. I do not pay Counil Tax, am over the age of 16 and give consent to the local authority to check my address on the electoral register
    2. I am applying on behalf of an applicant who is under 16, I give my consent to the local authority to check the school records
  6. Proof of your identity
    1. We need to check your identity to reduce fraudulent applications for a blue badge.

      Therefore please upload one of the following as proof of your dentity. This upload should be countersigned / certified by an autherised person

      See guidence notes - page 2 section 1b.

      Please upload one of the collowing

      Birth certificate / Adoption certificate

      Marriage / Divorce certificate

      Civil Partnership / Dissolution certificate

      Valid driving licence

    2. Photographs
      1. To ensure that you provide the required passport standard photograph please refere to the Guidence notes - Page 3, section 1c

        Please provide a scan or upload of a recent photograph of the applicant taken within the last month. The photo needs to show the applicants full face so that the holder can be easily identified. No one else should be in the photo. The photo will be placed on the back of the badge and will not be visable when the badge is on display in the vehicle

        Please ensure that the applicant's name is on the back of the photo and that you , the applicant complete section 6(a) and 6(c) of this form to confirm the photo is a true likness

    3. Blue Badge issue Fee:
      1. If your application is successful a £10.00 Blue Badge issue fee will apply. Notification will be sent advising you of successful application and that £10.00 is required.

        you will only be issued with a Blue Badge once payment has been recived

        For further informationplease refer to the Guidence Notes - Page4, Section 1d

  7. Please nominate the vehicle regisrtation for numbers(s) for the main car in which you intend to use the Blue Badge
    1. Up to 3 can be nominated, but please remeber that other vehicales can be used