Opt out of business rates relief 1Using the form2Declaration3About the business4Correspondence address5About the reason for opting out6Other information If you would like to opt out of receiving a retail discount, please use this form. Once we have received your form we will remove your discount and send you a revised bill. If receiving 50% discount on your property from 1 April 2022 will mean that you exceed the £110,000 cash cap, please use this form to tell us. This form will ask you to provide your name and position within the organisation your business rates account reference the full name of the ratepayer your business address and contact details correspondence address (if different from your current business address). This form must be completed by the ratepayer or someone authorised to do so on their behalf. Please have this information ready as pages time-out after one hour. Do not use your browser back button – if you need to go to a previous page click on the previous button at the bottom of each page. Privacy Statement Dover District Council is a Data Controller under GDPR. In submitting this form we will collect and process your personal data. For information about your rights and how the Council uses your data, please view our Corporate and relevant service privacy notice which can be found on our Privacy page. DeclarationPlease check the box below to indicate your acceptance of the following statements before completing this form: I confirm the information that I will give on this form will be correct and true.. I will notify you of any relevant changes within 21 days of the change. I understand that if I give information that is false this could lead to a penalty or legal proceedings being taken against me. I understand my data may be shared with other departments as permitted by law. I confirm I am the ratepayer or someone authorised to accept this declaration on the ratepayer’s behalf. Declaration(Required) I understand and accept the above declarationYour name(Required)Position in the company or organisation(Required)For example secretary, treasurer About the businessBusiness rates account reference(Required)You can find this on your business rates billBusiness nameRatepayer's full name(Required)Contact phone number(Required)Business website address (if applicable)Business email address(Required) Enter email address confirm email address Would you like to receive your business rates bills by email?(Required)You can receive your business rates bills by email rather than post. We will send all future business rates bills to the email address you have given above. If you change your email address you must let us know straight away. You can opt out of this at any time at dover.gov.uk/paperlessrates Yes No Address of the property for which you are applyingProperty address(Required) Address line 1 Address line 2 Town or city Postcode Correspondence addressIs the correspondence address the same as the address for which you are applying?(Required) Yes No Correspondence address(Required) Address line 1 Address line 2 Town or city Postcode About the reason for opting outIf you would like to opt out of relief, please check the appropriate box below and we will send you a revised bill without this discount. If receiving 50% discount on your property from 1 April 2022 will mean that you exceed the £110,000 cash cap, you must tell us by checking the appropriate box below. We will then remove your discount and send you a revised bill.Tell us why you're opting out of the retail discount(Required) I would like to refuse a retail discount from 1 April 2022 I am not eligible for a retail discount from 1 April 2022 Any other informationPlease use this box to tell us any other informationIf you have no further information to give, leave this box blank