Revenue and Benefit Service

Business Rates Team

Quadrant

The Silverlink North

Cobalt Business Park

North Tyneside, NE27 0BY

e-mail:

Tel: (0191) 643 2365

Name
Address
Part 1 – New Occupation
Occupier/Liable Party
Your New Business Address
Building Name/Property Number
Street
District / Town / Post Code
Tel No / e-mail
Date First Occupied or Furnished By You
Day / Month / Year
Home Address - Sole Traders and Partnerships Only
House Name/Number
Street
District / Town / Post Code
Tel No / e-mail

Do you wish future communication to be sent to your Home Address rather than your Business Address? Yes No

If Owner/Occupier complete Section 1,if Tenant/Leaseholder or Owner/Agency complete Section 2.

Section 1

Solicitors Acting on Your Behalf
Name
Address
Completion of Purchase Date
Day / Month / Year

Section 2

Name and Address of Owner
Name
Address
Tenancy/Lease Start Date
Day / Month / Year

Are the rates included in the rent?InclusiveExclusive

Other Information
Method of Payment
Monthly Direct Debit (please complete and return the direct debit mandate with this form)
Monthly Standing Order
Monthly Bacs Payment
Payment Slips
Payment Card

Name and Full Postal Address of your Bank or Building Society

Name(s) of Account Holder(s)

Branch Sort CodeBank or Building Society Account No

- / -

Instruction to your Bank or Building Society

Please pay North Tyneside Council Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this information may remain with North Tyneside Council and if so details will be passed electronically to my Bank or Building Society.

Signature(s): / Date:

This is not part of the instruction to your Bank or Building Society

Please indicate your preferred payment date.

10 Monthly Instalmentsor12 Monthly Instalments (April to March)

10th / 28th / 10th / 28th

The number of instalments provided in a financial year will be determined by the date of receipt of this instruction by the Council.

Your Business Rates Reference Number
Please leave a day time telephone number to help ourselves, your Bank or Building Society in case we experience problems setting up your Direct Debit.

For North Tyneside Council Official Use Only

Originators Identification Number / 9 / 7 / 1 / 9 / 4 / 2
Originators Reference Number

Banks or Building Societies please note this is the number North Tyneside Council will quote when claiming a Direct Debit.

Banks and Building Societies may not accept Direct Debit Instructions for some types of account.

------

Please remove this guarantee and retain for your records.

The Direct Debit Guarantee

This guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits.
If there are any changes to the amount, date or frequency of your Direct Debit, North Tyneside Council will notify you 10 working days in advance of your account being debited or as otherwise agreed. If you request North Tyneside Council to collect a payment, confirmation of the amount and date will be given to you at the time of the request.
If an error is made in the payment of your Direct Debit by North Tyneside Council or your bank or building society you are entitled to a full and immediate refund of the amount paid from your bank or building society.
-If you receive a refund you are not entitled to, you must pay it back when North Tyneside Council asks you to.
You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.

Part 2 – Vacation of a Property
Address of Property to be Vacated
Building Name/Property Number
Street
District / Town / Post Code
Tel No / e-mail
Date Which Premises Were Cleared
Day / Month / Year
Forwarding Address
Building Name/Property Number
Street
District / Town / Post Code
Tel No / e-mail

Were you the:

Owner/Occupier – if so please complete Section 1 below
Tenant – if so please complete Section 2 below
Leaseholder - if so please complete Section 2 below
Owner/Agent - if so please complete Section 2 below

Section 1

Prospective Purchasers Details
Name
Address
Purchase Completion Date
Day / Month / Year

Have any rates overpaid by vendor been reimbursed by purchaser? Yes No

If Yes, how much?

Vendors Solicitor / Purchasers Solicitor
Name / Name
Address / Address
Estate Agent
Name
Address

Section 2

Name and Address of Tenant/Leaseholder/Owner/Agent
Name
Address
Date Tenancy/Lease Terminated or Terminates
Day / Month / Year
Other Information
Part 3 - Declaration

I declare that the information I have given on this form is correct to the best of my knowledge and undertake to notify you immediately if my circumstances change and that change effects my liability for business rates.

Signature / Name
On behalf of / Date
Tel No / e-mail
Advice and information on Business Rates can be obtained via:
Tel: (0191) 643 2365
Fax: (0191) 643 2427
Minicom: (0191) 219 2440
email:
online:

Data Protection – What happens to the information you provide to us?

The information held on your account by North Tyneside Council’s Revenue and BenefitService will be used for administering and collecting Council Tax and Business Rates andfor the processing of Housing and Council Tax benefit claims.

The Revenue and Benefit Service may share your information with other North TynesideCouncil departments to make sure you are receiving all the benefits, discounts andexemptions to which you are entitled and to ensure you are paying the correct amount oftax.

Your information may also be passed to other North Tyneside Council departmentswhere appropriate, to enable the Council to effectively carry out the functions andservices it is required to provide by law. The Council must protect the public money it handles, and for this purpose we may passyour information to other parties who may use the information to detect and preventcrime and fraud.

For further information on how the Council may use your information, how we maintainthe security of your information and your rights to access the information the Councilholds on you, you can visit our website at: