Retail Discount Application Form Non-domestic rates Retail Discount application To apply for retail discount, complete the form below. Once your application is received, we will write to you to confirm the exact amount of relief we are awarding. PART 1: Your details Billing number Business name Your name First name Last name Position in company Phone Mobile Email Business address Address Line 1 Address Line 2 City County Postcode Country Provide a brief description of the nature of your business and the services provided. PART 2: State Aid De Minimis declaration Awards such as Retail Discount are required to comply with the EU law on State Aid. In this case, this involves the submission of this application form to this authority if you have received any other De Minimis Stated Aid, including any other Retail Discount you are being granted for premises other than the one to which you are now applying for, and confirming that the award of Retail Discount does not exceed the €200,000 an undertaking can receive under the de minimis Regulations EC 1407/2013. To establish whether you are eligible to receive De Minimis aid you must declare the full amount of De Minimis aid which you have already been granted during the previous two financial years and the current financial year. Any assistance you may have received from a public body might be a De Minimis aid. This could be from central, regional, devolved governments or agencies or a local authority. Select on declaration I have NOT received De Minimis aid in any of the last three financial years (go to PART 3)I have received De Minimis aid in the last three financial years (complete the section below before moving onto PART 3) If you have received De Minimis aid in the last three financial years, state the amount of aid provided, its nature, the provider, and the date received: PART 3: Declaration Declaration I certify that full details of any assistance received under the De Minimis aid scheme have been declared above, and where no aid has been received, I have stated so. I declare all particulars are correct, and understand that if I supply incorrect information it will invalidate my application. Submit