Property reference number * Account number * Organisation name * Organisation address Building name or number * Address line 1 * Address line 2 * Address line 3 Address line 4 Postcode * Are you applying for relief for this address? * Yes No Building name or number * Address line 1 * Address line 2 * Address line 3 Address line 4 Postcode * When did you begin occupying this property? * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year20172018201920202021 Named contact This is normally the business owner or a secretary at the organisation. First name * Last name * Work phone number Work mobile phone number Email address Which of the following most accurately describes your business? * Shop (such as: florist, bakers, butchers, grocers, greengrocers, jewellers, stationers, off licence, chemists, newsagents, hardware stores, supermarkets, etc) Charity shop Optician Post office Furnishing shop/display room (such as: carpet shop, double glazing, garage doors) Car/caravan show room Second hand car lot Market Petrol station Garden centre Art gallery (where art is for sale/hire) Hair and beauty services (such as: hair dressers, nail bars, beauty salons, tanning shops, etc) Shoe repairs/key cutting Travel agents Ticket office (e.g. for theatre) Dry cleaners Launderette PC/TV/domestic appliance repair Funeral director Photo processing DVD/video rentals Tool hire Car hire Restaurant Takeaway Sandwich shop Coffee shop Pub Bar Other Please specify * Charity relief Charities and amateur sports clubs can apply for relief if a property is used for charitable purposes. Please select if you would like to be considered for charity relief I would like to be considered for charity relief Please state if the charity registered with The Charity Commission HEFCE (Higher Education Funding Council for England) Secretary of State for Education Registration number * Date of registration * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019 Is the property used wholly or mainly for charitable purposes? * Yes No What percentage of goods is donated? * % Please select if you would like to be considered for discretionary charity relief I would like to be considered for discretionary charity relief What is the charity's geographical area? Local charity National charity Other Do the charitable objectives benefit local residents? Yes No Do the charitable objectives benefit local residents more than in other parts of the country? Yes No What are the main charitable objectives of your organisation? If the property is used for any other purpose, please give details here You may wish to provide documentary evidence to support your application. You can upload a file here. We are specifically looking for evidence that the charity benefits local people.Files must be less than 2 MB.Allowed file types: gif jpg jpeg png bmp txt pdf doc docx ppt pptx. Rural relief Relief on business rates is available if your business is located in a rural settlement of less than 3,000 people, or if your business is operating on land or buildings formerly classed as agricultural land or buildings. Please select if you would like to be considered for rural relief I would like to be considered for rural relief What type of village business do you have? Food shop General store Post office Pub Petrol station Other Please specify Brief outline of goods sold Is this the only facility of its kind in the village? Yes No Opening hours Which days are you open? Monday Tuesday Wednesday Thursday Friday Saturday Sunday Monday From Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 To Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 Tuesday From Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 To Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 Wednesday From Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 To Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 Thursday From Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 To Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 Friday From Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 To Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 Saturday From Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 To Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 Sunday From Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 To Hour Hour01234567891011121314151617181920212223 : Minute Minute00153045 Do you employ local residents? Yes No Does the business provide a local delivery service? Yes No Do you provide a service to the local community? Yes No Please add additional notes to support your case Details such as the regularity of public transport to the village and how far away the nearest business like yours is. Is your business operating on land or buildings formerly classed as agricultural land or buildings? Yes No Declaration * I certify that I have filled out this application to the best of my knowledge, and that the information on this form is true and complete. I understand that it is a criminal offence to give false information when making an application and that I have a duty to inform the council of any change in circumstances my eligibility for any of the above reliefs.
