Application 5
Non-Domestic Rates Statement of Financial Entitlements Application
Provider Information
- Provider Name
- Not provided
- Contract Number
- Not provided
- Provider Address
- Not provided
- Email Address
- Not provided
- Other Addresses
- Not provided
Payment Responsibility
- Solely Responsible
- Yes
- No Reimbursement Confirmed
- Yes
- Fraud Disclosure Consent
- Yes
Financial Details
- NHS Percentage
- Not provided
- Council Demand
- Not provided
- Bill Payment Method
- 1st Half year
- Total Reimbursement Requested
- Not provided
- Reimbursement Period
- Not provided
SBRR Information
- SBRR Claimed
- Yes
Supporting Information
- NHS % (with evidence)
- Not provided
- Signature
- 321
- Date Signed
- Not provided
Submission Details
- Submitted Date
- 11 July 2025 at 02:34
- Client IP
-
86.9.8.227 - Application ID
-
5
Actions
Manage this application:
Contact Provider
No email address provided
Warning
This application contains personal data. Handle in accordance with GDPR and data protection policies.