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Rates Payment Refund
Rates Payment Refund
1. Customer Account Number
2. Rate (Property Reference) Number
3. Company/Business Trading Name
4. Company Registered Name
5. Revenue Registration Number
6. Business Premises Address Line 1
7. Business Premises Address Line 2
8. Business Premises Address Line 3
9. Proprietor/Applicant Name
10. Position in Company
11. Email Address
12. Confirm Email Address
13. Phone Number
14. Bank Account Name
15. BIC
16. IBAN
Declaration
By submitting this form, I am confirming that all details are correct and true.
Signature
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