Liverpool Direct National Non Domestic Rates Application For Small Business Rate Relief

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National Non Domestic Rates
Application for Small Business Rate Relief
Please fill in this form using BLOCK CAPITALS and black ink.
Section 1: Address of business property to which this application relates:
Address
Account Number
Name
Home phone number
Mobile phone number
E-mail address
The valuation period or partial valuation period for which relief is sought
Section 2: If the application is the first application in the valuation period in respect of a
Business premises give the full address of:
(a) The business premises for which Small Business Rate Relief is sought
(b) Any other business premises in England that you occupy
I confirm that the business premises listed in section 2 are the only business premises in
England occupied by :-
Name
Signed
Signature of the ratepayer/person authorised to
sign on behalf of the ratepayer.
Capacity of person signing
Date:
/
/
Section 3: If the application is being made to notify the billing authority of a change in
circumstances but the business premises for which the ratepayer is seeking relief
remains unchanged, state -
(a) any additional business premises in England
which you have started to occupy since making your
first application for the valuation period
(b) the date on which you started to occupy the business premises
/
/
I confirm that the changes listed in section 3 are the only changes relating to the business
premises in England occupied by;-
Name
and the date of those changes are correct.
Signed
Signature of the ratepayer/person authorised to
sign on behalf of the ratepayer.
Capacity of person signing
Date:
/
/
It is a criminal offence for a ratepayer to give false information when making
an application for Small Business Rate Relief
You can hand this form in at any of our One Stop Shops, or post it to
Business Rates PO Box No 2012 Liverpool L69 2DX or fax it to: 0151 225 3847
If you have any further enquiries please telephone 0151 225 3409

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