Resources Directorate, PO Box 2, Wharncliffe Road, Ilkeston, Derbyshire, DE7 5SE

Resources Directorate, PO Box 2, Wharncliffe Road, Ilkeston, Derbyshire, DE7 5SE

Business Rates Direct Telephone: 0115 9071090 e-mail:

1. / Name of Charity or Organisation on whose behalf this application is made and Account Reference Number

Registered Charities:

2. / Charity Commission Registration No. / Date of Registration
Applications for Rate Relief must be accompanied by:

A copy of the Governing Document which specifies the purpose of the organisation, and indicates how it is administered. This may take the form of a Trust Deed, Constitution, Memorandum and Articles of Association, Will, Conveyance or Rules of the Organisation.

Copies of the audited accounts and balance sheets for the last two years.

Non-Registered Charities:

Yes / No
3. / Is your organisation exempt from registration as a charity? / PLEASE SUPPLY EVIDENCE IN THE FORM OF DOCUMENTS
LISTED ABOVE TO SUPPORT
YOUR APPLICATION
4. / Is your organisation registered with the Secretary of State for Education?
5. / Is your organisation a Sports or Recreational Club without Community Amateur Sports Club Status?
6. / Are the main objectives of your organisation recreational, cultural, religious, philanthropic or concerned with social welfare, science, fine arts or literature?
7. / Main objects and purposes of the charity or organisation:

Yes / No
8. / Are properties accessible to all members of the communityincluding those with disabilities?

Address(es) of premises for which relief is sought:

9. / Property Reference No. / Property ReferenceNo.
10. / For what purpose are the above premises used?
Yes / No
11. / Are the premises listed above used by any other organisations?
If so, please list them. For regular bookings, list fees levied and day of usage each week/month.
If the premises are used as a charity shop, please answer questions 12 to 15:
Yes / No
12. / Are the premises temporarily or permanently occupied?
13. / Are staff unpaid volunteers, paid employees or both?
Please state numbers, roles and whether full-time or part-time.
14. / Approximately what percentage of goods are donated? / %
15. / Explain the purpose to which the proceeds of all sales (after expenses) are applied:
16. / Please explain how the charity or organisation is funded and if in receipt of any grants, list the provider and amount contributed:
17. / Please provide details of all membership fees and/or joining fees:
Yes / No
18. / Are any special conditions attached to membership?
If Yes, please specify:
Yes / No
19. / Are staff unpaid volunteers?
If paid staff, please state number and function:
20. / What percentage of members reside in the EBC area, and how does membership benefit them? / %
Yes / No
21. / Does the organisation operate a licensed bar on the premises listed
If Yes, please answer the following questions:
Yes / No
22. / Is the bar staffed by paid employees?
23. / Are bar prices subsidised?
Members / All
24. / Is bar usage restricted to members only or open to the general public?
Declaration: I hereby certify that the particulars given above are correct to the best of my knowledge and belief.
Signature / Date / Capacity (ratepayer, Director etc)
E-mail address: / Website address:

This application must be signed by the ratepayer or a person authorised to sign on behalf of the ratepayer. Authorised person means partner of a partnership, trustee of a trust, director of a corporate body or in any other case, a person duly authorised.

Warning: It is a criminal offence for a ratepayer to give false information when making an application for charitable rate relief.

Please return the completed and signed application form with appropriate documents to the Business Rates (NNDR) Section at the address given at the top of the page.

ALL DOCUMENTS WILL BE RETURNED UPON REQUEST AFTER THE APPLICATION HAS BEEN CONSIDERED.