Refund Request

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Entries marked with * are mandatory.

Declaration
I understand that by completing this form, I am claiming a refund of council tax or business rates to which I am entitled.
If I am claiming a refund where other people were liable for the council tax or business rates at the same time as me, I understand that by completing this application form, I am stating that I have the express consent of all of those persons to claim this refund.
I understand that to knowingly claim a refund to which I am not entitled is fraud and could render me liable to criminal prosecution.
I have read and accept the above declaration *