{"id":35677,"date":"2025-07-01T15:12:57","date_gmt":"2025-07-01T14:12:57","guid":{"rendered":"https:\/\/www.1625ip.co.uk\/?page_id=35677"},"modified":"2025-07-01T15:12:57","modified_gmt":"2025-07-01T14:12:57","slug":"arrears-repayment-agreement-form","status":"publish","type":"page","link":"https:\/\/www.1625ip.co.uk\/fr\/arrears-repayment-agreement-form\/","title":{"rendered":"Formulaire d&#039;accord de remboursement des arri\u00e9r\u00e9s"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework form_1625ip_wrapper' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_30' >\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Arrears Repayment Agreement form<\/h3>\n                            <p class='gform_description'>Arrears Repayment Agreement form<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_30' class='form_1625ip' action='\/fr\/wp-json\/wp\/v2\/pages\/35677' data-formid='30' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6Le2aTUqAAAAAFBcInaAvJ13_znorAWMrpPp-4Vv' data-tabindex='0'><input id=\"input_61a3b3b7f96e43b40a4e57e41b39dea3\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_61a3b3b7f96e43b40a4e57e41b39dea3\" value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><ul id='gform_fields_30' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_30_33\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_30_33'>\n                            \n                            <span id='input_30_33_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_33.3' id='input_30_33_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_30_33_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_30_33_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_33.6' id='input_30_33_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_30_33_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_30_59\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_59'>Email address<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_59' id='input_30_59' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_30_7\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_7'>Address<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_7' id='input_30_7' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_30_4\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_4'>Total personal arrears today<\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_30_4' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_30_34\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_34'>Form completed by<\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_30_34' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_30_41\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\"><\/h2><div class='gsection_description' id='gfield_description_30_41'>By completing the form below, you are making a proposal to 1625ip to repay your outstanding arrears in a way which you deemed to be affordable. \n\nPlease bear in mind that this must be a sustainable amount for you to pay each month.\n\nIf your proposal is considered suitable and accepted, then this will mean entering into a payment agreement with 1625.\n \nIf you are completing this form with your support worker, then they will advise you of what is a suitable amount based on your circumstances.\n \nYou must keep to the agreement to avoid any letters or further action being taken.\n \nIf you are unable to make a payment or your circumstances change you must contact your support worker\/ 1625 as soon as you become aware.\n\n\nIMPORTANT: If you do not keep to the agreement and you don\u2019t contact us to discuss the matter, we will pursue the debt and, in some cases, this may mean referring your account to a debt collection agency.<\/div><\/li><li id=\"field_30_43\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Please tick to confirm you have read and understood the statements<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_30_43'><li class='gchoice gchoice_30_43_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.1' type='checkbox'  value=''  id='choice_30_43_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_43_1' id='label_30_43_1' class='gform-field-label gform-field-label--type-inline'><\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_30_63\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_63'>Total arrears amount expected the start of the agreement: \u00a3<\/label><div class='ginput_container ginput_container_number'><input name='input_63' id='input_30_63' type='text' step='any'   value='' class='large'      aria-invalid=\"false\" aria-describedby=\"gfield_description_30_63\" \/><\/div><div class='gfield_description' id='gfield_description_30_63'>Please include up to 4 weeks\u2019 charge for a notice period if someone is moving on, and any miscellaneous balances such as key replacements.<\/div><\/li><li id=\"field_30_64\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_64'>The amount I can pay will be: \u00a3<\/label><div class='ginput_container ginput_container_number'><input name='input_64' id='input_30_64' type='text' step='any'   value='' class='large'      aria-invalid=\"false\" aria-describedby=\"gfield_description_30_64\" \/><\/div><div class='gfield_description' id='gfield_description_30_64'>If you\u2019re a current resident, this amount must cover both your rent\/service charge AND an additional contribution to your arrears. This repayment plan will also be reviewed by your support worker before it is approved. <\/div><\/li><li id=\"field_30_48\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_48'>Payments start date<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_48' id='input_30_48' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon'   placeholder='jj\/mm\/aaaa' aria-describedby=\"input_30_48_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_30_48_date_format' class='screen-reader-text'>JJ slash MM slash AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_30_48' class='gform_hidden' value='https:\/\/www.1625ip.co.uk\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_30_50\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Payments thereafter will be made<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_30_50'><li class='gchoice gchoice_30_50_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.1' type='checkbox'  value='Weekly'  id='choice_30_50_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_50_1' id='label_30_50_1' class='gform-field-label gform-field-label--type-inline'>Weekly<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_50_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.2' type='checkbox'  value='Fortnightly'  id='choice_30_50_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_50_2' id='label_30_50_2' class='gform-field-label gform-field-label--type-inline'>Fortnightly<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_50_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.3' type='checkbox'  value='Monthly'  id='choice_30_50_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_50_3' id='label_30_50_3' class='gform-field-label gform-field-label--type-inline'>Monthly<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_30_52\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Payment Method<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_30_52'><li class='gchoice gchoice_30_52_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.1' type='checkbox'  value='Standing Order (recommended)'  id='choice_30_52_1'   aria-describedby=\"gfield_description_30_52\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_30_52_1' id='label_30_52_1' class='gform-field-label gform-field-label--type-inline'>Standing Order (recommended)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_52_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.2' type='checkbox'  value='Bank transfer'  id='choice_30_52_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_52_2' id='label_30_52_2' class='gform-field-label gform-field-label--type-inline'>Bank transfer<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_30_52_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.3' type='checkbox'  value='1625 Website'  id='choice_30_52_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_52_3' id='label_30_52_3' class='gform-field-label gform-field-label--type-inline'>1625 Website<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_30_52'>Your payments must be on time, or you speak to us beforehand, otherwise you risk escalation of debt recovery being taken against you. If you do not set up a standing order with your bank, you must set yourself reminders to pay via bank transfer or on our website, as per the terms of this agreement. All transactions need to be accurately labelled with your tenancy ID<\/div><\/li><li id=\"field_30_53\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_53'>This agreement can be reviewed if my circumstances change, or by<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_53' id='input_30_53' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon'   placeholder='jj\/mm\/aaaa' aria-describedby=\"input_30_53_date_format gfield_description_30_53\" aria-invalid=\"false\" \/>\n                            <span id='input_30_53_date_format' class='screen-reader-text'>JJ slash MM slash AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_30_53' class='gform_hidden' value='https:\/\/www.1625ip.co.uk\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><div class='gfield_description' id='gfield_description_30_53'>Fill this in if you\u2019re anticipating changes in your income, benefits or circumstances, such as being on a zero-hour contract.<\/div><\/li><li id=\"field_30_57\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_30_57'>Please complete and sign: Resident<\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_30_57' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_30_58\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_30_58'>Please complete and sign: 1625 worker<\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_30_58' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_30_60\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_60'>Signature<\/label><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_30_60_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><input type='hidden' class='gform_hidden' name='input_30_60_valid' id='input_30_60_valid' \/><canvas id='input_30_60' width='300' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/www.1625ip.co.uk\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_30_60_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id = 'input_30_60_resetbutton' src='data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAABgAAAAYCAYAAADgdz34AAAAGXRFWHRTb2Z0d2FyZQBBZG9iZSBJbWFnZVJlYWR5ccllPAAAAtRJREFUeNrsld9rklEYx32nc7i2GulGtZg6XJbJyBeJzbGZJJVuAyFD7D8QumiG7nLXQuw6dtHN7oYwFtIgDG+2CGQtGf1grBpWIkPHaDpJZvZ95F2cqfPHRTfRgY\/H85znfb7nPc85z8sVi0XR32zcf4GmBTiOk8GWY8YSdEpwHpwG7eAA\/ABJsA3\/w5MEJOUGi8VyCUFFeCiGvlcsFvOFQqGtzK1d4Bzmr8DvDfy\/NyTgcDj6I5GIGA91YdiN4CW7RqNp83g8fZ2dna17e3v5ubm5r1tbWz8F8WH4v4PIh7oCTOumH4VCIQkGg6axsTElgkRhyoJTXq\/33srKStzpdL5KpVK0RVcxvw+Rb40KlNr09LTSbDZH8HcJ\/DqyY2sksE9Go1GHVqsN5fP5Yk9Pz3WIJNmctNQT8Pl8n\/DQZza40CjIokqlerywsMCTYWdnpwVjTb0kF1dXVy2sLR6Pn4HIJnu6mLZht9s3KUeUE7VarYPt459ZOqZlKMFEFRRVfI+QzMzMeBHOOTAw4GbnKt4AK6Vte0\/nHA6pBu\/T4ejoqAgnS4dTlT82U74aJOourYTn+ds1VlyNm+AReMjaK5LsdrvpxoqSyWSX8DbVSwDHtYJ+hi9gETxl\/SoCWK1WGfWJRKLQ0dGhO0kAq5MGAoFB\/OVZXC6XtqYAzvamwWCgMiDK5XKXsSL5CRpZv98vnp+fH2SNJpPpYk0BlIIXSJaB\/lOZkEqlNyCi4ahAHd8iajGUj41a2a+2xzmj0fgsFAoN0QA3lAJfAxMISDeVpx7jSbJnMplSOZ6amuptVIBaZHx8\/G0sFruj1+tlgo2KWh\/oF3opGWl+bW3t1uzsrHJ5eXm42Q+OGW\/wADc7gYe3w+Fwen19\/YByhMMgt9lsqpGRkQvYxifwfQnup9PprFwuX2rmi0ZvYAdDwurPgl1A9ek1eE7byqYR7P873+TfAgwATQiKdubVli0AAAAASUVORK5CYII=' 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