Application Form for Discretionary Relief in Respect of National Non-Domestic Rates

Application Form For Discretionary Relief in respect of National Non-Domestic Rates Account Number:

Applicants are advised to check the explanatory notes below before making an application to ensure that the restrictions imposed by this policy do not prevent an award from being made in their circumstances.

There are circumstances where the Council will not award any discretionary relief.

1) What is the full name of the charity or organisation?

2) What is the address for which relief is being claimed?

3) What is the charity registration number (if you are applying as a charity)?

4) What are the principal objectives of the charity or organisation?

5) What are the purposes for which the building in question is used?

6) Is the charity or organisation affiliated to a local or national organisation? Yes/No If yes, please give details.

7) How does the charity or organisation support Brent’s corporate priorities?

8) Does the charity or organisation provide facilities which indirectly relieve the Council from the need to do so, or supplement those that it does provide, and if so how? 9) Is the charity or organisation national or local (i.e. operating mainly within Brent and mainly for Brent residents)?

10) Is the membership drawn mainly from Brent residents? Please detail.

11) Please give details of annual membership subscription rates.

12) Are members paid to participate? Please detail.

13) Is membership open to all sections of the community? If not, please give reasons.

14) Is membership actively encouraged from particular groups in the community? If so, give examples

15) Are facilities made available to non-members and if so, for what reasons?

16) Does the charity or organisation provide training or education for its members? Yes/No If yes, please give examples.

17) Have the facilities available been provided by self help or grant aid? If grant aided, please state from whom, the amounts and dates if within the last 12 months.

18) Does the charity or organisation run a bar? Yes / No If so, please provide copies of the latest audited accounts. 19) What are the (other) sources of income for the charity or organisation ?

20) Have you any other information to support your application? If so, please provide details below or attach to this application.

The following must also be included with the application;

1 Copy of the Memorandum and Articles of Association or Rules of Association 2 Copies of the audited accounts and balance sheets for the last 2 years. 3 Supporting evidence, such as literature, training plans etc.

I confirm that the information given above is correct to the best of my knowledge.

Signed

Date Phone No Email

Name Position in organisation

Please return to: [email protected] or send to:-

London Borough of Brent Business Rates PO Box 425 Wembley Middlesex HA9 6SU

Data Protection This authority is under a duty to protect the public funds it administers, and to this end may use the information you have provided on this form within this authority for the prevention and detection of fraud. It may also share this information with other bodies administering or in receipt of public funds solely for these purposes.

This authority is under a duty to protect the public funds it administers, and to this end may use the information you have provided on this form for the prevention and detection of fraud. It may also share this information with law enforcement agencies and other bodies responsible for auditing or administering public funds for these purposes.

For further information, see Brent Council’s privacy statement http://www.brent.gov.uk/privacy