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Application 6

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
23.00%
Council Demand
£325.04
Bill Payment Method
Monthly instalments
Total Reimbursement Requested
£153.98
Reimbursement Period
16 July 2025

SBRR Information

SBRR Claimed
Yes

Supporting Information

NHS % (with evidence)
32.00%
Signature
3232
Date Signed
17 July 2025

Submission Details

Submitted Date
11 July 2025 at 02:38
Client IP
86.9.8.227
Application ID
6

Actions

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No email address provided

Warning This application contains personal data. Handle in accordance with GDPR and data protection policies.