Moving out of a property

Name of vacating occupier

Title: *

First name: *

Surname: *

Vacated address

House name/number:

Postcode: *

Floor Number:

Office Number:

Phone number: *
If we need to phone you our number will show as withheld.

Email address:

Please note that we may use your email address for future correspondence.

Please enter a valid email address or leave blank if you do not have an email address

Business rates account number:

Company title/trading as: *

Name of ratepayer(s): *

Date of vacation: *

Date the stock was removed from premises: *
This will be the date furniture or goods were moved out

Do you own the property? *

Are they company? *

Are you: *

Date your lease ended: *

Provide address for future correspondence to be sent.

House name/number:

Postcode:

Address: *
You can enter the house name/number and postcode above to populate this field.

Provide details of the new occupier of the property you are leaving (if know)

Title:

First name:

Surname:

New occupiers correspondence address

House name/number:

Postcode:

Address:
You can enter the house name/number and postcode above to populate this field.

Data Protection

The information you have provided on this form will be used to deal your request by the relevant department. We may pass your details on to contracted third party service providers. We will store a copy of your completed request as a backup for 12 months.

If you would like to know more about how we use your information and how you can exercise your information rights please see our privacy notice.

Failure to complete this form may result in a fine of up to £5,000

I understand the following:

If I give information that is incorrect or incomplete, you may take action against me. That the information I have provided will be used to amend my Business Rates account
You may check some of the information with other sources as allowed by the law.
I have read, or had read to me, and understand the information on this form.

I know I must let the council know about any change in my circumstances which might affect my account.
I declare the information I have given on this form is correct and complete.

Please tick to confirm you accept these conditions.