Form A: cash cap declaration form

If you (or if appropriate, a company in your Group) have received Expanded Retail Discount on any other property then you should return the declaration to this authority including any other Expanded Retail Discount you are being granted for premises other than the one to which this bill and letter relates, and confirming that the award of Expanded Retail Discount does not exceed the cash cap for 2021/22.

See guidance on the cash cap in the Guidance for Expanded Retail Discount

Please complete and submit

Your Name *

Position in business *

Business Address *

Non-domestic rates account number *

Your contact telephone number *

Amount of Expanded Retail Discount *

I confirm that:

I am authorised to sign on behalf of [name of ratepayer] *

AND

I declare that the above named ratepayer shall not exceed Expanded Retail Discount Cash Cap by accepting this Discount *