Current Start Preview Complete Your details Name Customer name Title Title - Select -MissMsMrMrsDrOther… Enter other… First name Last name Address Customer address First line of address Second line of address City/Town Postcode Contact Contact details Email Phone number Other details? Date of Birth National Insurance Number? Allotment site details Allotment Site - Select -Amos Lane, WednesfieldBlakeley Green, AldersleyBoots Land , Bridgnorth Road, ComptonBoundary Way Self-Managed, PennCompton Road, ComptonCrowther Road Self-Managed, NewbridgeDunstall Park Self-Managed, Whitmore ReansFalcon Crescent, WoodcrossHarrowby Road, FordhousesHeath Town, Park VillageHimley Crescent Self-Managed, Goldthorn ParkHowell Road Self-Managed, ParkfieldsKitchen Lane, Ashmore ParkLichwood Road, WednesfieldMount Road Self-Managed, PennNorth Avenue, WednesfieldNursery Walk Self-Managed, TettenhallOxbarn Avenue Self-Managed, PennPenn Road Self-Managed, PennPhillips Avenue, Ashmore ParkPrimrose Avenue, BushburyPrincess Anne Road, BradleyRedhouse Road, TettenhallRenton Road, RakegateRuskin Road, Low HillSandy Lane Self-Managed, BushburySandy Lane, ClaregateStanley Close, Ashmore ParkThe Droveway Self-Managed, PendefordWhiston Avenue, Ashmore ParkWindsor Avenue, Penn Plot numbers Date wishing to end tenancy Reason for terminating your tenancy Reason for terminating your tenancy - Select -Moving houseIll healthNot enough timeOther… Please state Are there any comments you would like to make? Confirmation I agree that by ticking this box, I am confirming that I wish to terminate my tenancy of the above allotment plot(s) and that I understand the conditions below: When vacating your plot(s), all material should be removed, and the plot(s) left in a clean, clear condition as detailed in your Tenancy Agreement. Failure to comply may incur costs that will be charged to your account. There is a £10 charge for non-return of site key, so please return this to your Site Secretary. 18033