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Please ensure you have read the information on small business rate relief before you complete this form
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Change of circumstances
It is a criminal offence for a ratepayer to give false information when making an application for Small Business Rate Relief.
I confirm that the rateable assessment(s) listed above are the only assessment(s) in England occupied by the small business applying for this relief.
I confirm that the changes listed above are the only changes relating to the rateable assessment(s) in England occupied by the small business applying for this relief, and the date of those changes has been accurately stated.
I confirm that I have read and understood the declaration above *