Organisation details


Name


Address details

Address of rated premises

Address


Contact details

Name

Customer name
Title

Correspondence Address (if different from above)

Correspondence address

Contact


Business details

Interest in property

Owner details

Name


Address

Owner address

Contact details


Additional details


Is this the only business premises that you pay business rates for in England or Wales?
If applicable would you like to apply for Small Business Rate Relief?
Will the premises be predominantly for retail use?

Person completing this form

Your name

14897