Form A - Declaration of Cash Cap and Exemption Threshold

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By completing this form you are confirming that the registered business named below shall comply with the cash cap on claiming the 2022/23 Retail, Hospitality and Leisure (RHL) Relief and the exemption threshold on the basis that, including this award, (together with any other companies in the same Group) shall not receive more than £110,000 of the Retail, Hospitality and Leisure Relief Scheme for eligible properties within 2022/23 and shall not receive more than £343,000 in total of Small Amounts of Financial Assistance over three years (including 2022/23).

Guidance on the cash cap and Small Amounts of Financial Assistance limit can be found at: https://www.gov.uk/government/publications/business-rates-guidance-202223-retail-hospitality-and-leisure-relief-scheme

Email *

Business Rates Account Number *

Please see your latest business rates bill or from the letter/email we have sent you

Name of Ratepayer/Business *

As shown on your latest business rates bill

Name *

Please provide your full name

Position *

E.g. Director, Sole Trader

Telephone Number *

Please provide a contact telephone number

Property Address *

Full address of the property in London Borough of Sutton

Please list any RHL Reliefs provided in 2022-23 *

Please include value of relief for 2022-23.

Property Reference No & Local authority providing subsidy for 2022-23 *

Please include the property reference number(s) and the Local Authority providing subsidy.

Please list any other subsidies received (excluding RHL relief for 2022/23) *

Please include values of other subsidies provided for 2020-21 to 2022-23.

Property Reference No & Local authority providing subsidy for 2020-21 & 2021-22

Please include the property reference number(s) and the Local Authority providing subsidy.

Declaration Date *

YYYY

Declaration *

Please tick both options

I confirm that I am authorised to sign on behalf of the business/ratepayer and

The business shall not by accepting this relief exceed the £110,000 cash cap limit for 2022/23 Retail, Hospitality and Leisure Relief Scheme or the Small Amounts of Financial Assistance limit of £343,000 over three years (including 2022/23).

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