Application for Business Rates Retail Discount 2021/22

1) Please provide account details for which relief is being claimed
1. Account Reference (shown on your business rates bill)*
2. Ratepayer name*
2) Property for which relief is being claimed
1. Property for which relief is being claimed*
3) Please provide details of how the property is being used
1. Provide details of how the property is being used*
4) Please confirm that the property is wholly or mainly used for one of the qualifying criteria as detailed on Gosport Borough Council's website
1. Qualifying criteria on Gosport Borough Council website
2. *
  
  Yes
  
  No
DECLARATION:

I CONFIRM THAT TO THE BEST OF MY KNOWLEDGE, THE INFORMATION CONTAINED ON THE FORM IS COMPLETE AND IS NOT FALSE. I UNDERSTAND THAT WILLFULLY MAKING A FALSE STATEMENT ON THE APPLICATION FORM IS AN OFFENCE AND MAY RESULT IN THE WITHDRAWAL OF ANY RELIEF AWARDED INAPPROPRIATELY AND LEGAL ACTION MAY BE TAKEN.
I am authorised to sign on behalf of :
1. Name*
2. Date*
3. Position in Organisation*
4. Telephone*
5. Email

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