Business Rates – Retail Relief Please return this completed form to Salford City Council, Customer Services, Unity House, Salford Civic Centre, Chorley Road, Swinton, M27 5AW or upload it on our website at www.salford.gov.uk/contacts-email Account Number: Name of ratepayer: Property address: Brief description of business: State Aid Further information on State Aid can be found at www.gov.uk/state-aid Please list all previously received State Aid below, including the total amount of this and any other Retail Relief you are being granted (continue on a separate sheet if necessary): Amount of De Minimis State Aid e.g. £1,000 Date of aid e.g. 01-Apr-2014 to 31Mar-2015 Organisation providing aid e.g. Salford City Council Nature of aid e.g. Retail Relief Examples of State Aid include: State grants interest rate relief tax relief tax credits State guarantees or holdings State provision of goods or services on preferential terms direct subsidies tax exemptions preferential interest rates guarantees of loans on especially favourable terms acquisition of land or buildings either gratuitously or on favourable terms provision of goods and services on preferential terms indemnities against operating losses reimbursement of costs in the event of success State guarantees, whether direct or indirect, to credit operations preferential re-discount rates dividend guarantees preferential public ordering deferred collection of fiscal or social contributions assistance financed by special levies capital transfers certain state holdings in the capital of undertakings Declaration I confirm that the property is wholly or mainly used for the type of business as briefly detailed above. I confirm that the value of Business Rates Retail Relief to be provided by Salford City Council will comply with the EU law on State Aid on the basis that, including this award, the ratepayer will not receive more than €200,000 in total of State Aid within the current financial year or the previous two financial years. I confirm that I am the ratepayer or authorised to sign on behalf of the ratepayer and that to the best of my knowledge all of the information detailed on this form is true and correct I understand that Salford City Council can make any checks and enquiries necessary in order to consider this application, which may include a visit to the property. I understand that if I become aware of any reason why Retail Relief is no longer applicable or that a smaller amount applies, I should notify Salford City Council as soon as possible but no later than 21 days of becoming aware of this. Failure to do so may lead to prosecution in the criminal courts. I understand that any information provided to Salford City Council for Business Rates will be processed in accordance with the Data Protection Act 1998 and that we may match information held internally on our records where the law allows us to do so and use information for the prevention and detection of fraud as well as share information with other organisations where appropriate. Signature: Date: Name: Position: Telephone: Email: Please note that under the European Commission rules, you must retain a copy of this form for 3 years and produce it on any request by the UK public authorities or the European Commission. (You may need to keep a copy longer than 3 years for other purposes). Furthermore, information on this award of State Aid must be supplied to any other public authority or agency asking for information on De Minimis State Aid for the next 3 years.