Application for Retail Hospitality and Leisure Relief (Retail Discount)

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 wilfully 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 confirm that the cash cap of £110,000 will not be exceeded and we will not receive more than £315,000 in total on Minimal Financial Assistance over 3 years. If the limits are exceeded I will notify you immediately.
I am authorised to sign on behalf of :
1. Name*
2. Date*
3. Position in Organisation*
4. Telephone*
5. Email

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