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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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Please add your bank statement header only. Please browse your local drive and attach image or pdf by using the “Chose File” button below. File size cannot be more than 20 Mb.
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