Document 12922887

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REVENUE SERVICES,
HOLT ROAD, CROMER, NORFOLK, NR27 9EN
TEL 01263 513811
FAX 01263 515042
EMAIL [email protected]
For help with understanding this document, or to receive it in a different
Format or language, please phone 01263 513811 or email the address above
Application for Single Occupier Discount
25% Discount
Qualifying Criteria
The Council Tax charge is based on 2 adults living at the property. To qualify for a discount,
there must only be 1 person living at the property.
Council Tax Reference No
Name and Address of Liable Person
Are you the only person (AGED 18 OR OVER) who normally lives at the property?
Yes
No
(Please tick box)
Date discount requested from ……………………………
Reason for request ………………………………………………………………………….
…………………………………………………………………………………………………
If NO please advise details of persons living in this property.
Name
Previous Address
Date moved in
Date of Birth
…………… ……………………………. ………………..
………………
…………… ……………………………. ………………..
...……………
Declaration
I declare that the information given above is correct to the best of my knowledge and
belief and I understand that if I have knowingly given false information I may be liable
for prosecution for attempting to obtain pecuniary advantage by deception.
Full Name: …………………………………….. Signature …………………………
Date: ……………………………… Telephone Number: ………………………….
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