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Application 14

Non-Domestic Rates Statement of Financial Entitlements Application

Provider Information

Provider Name
ertert
Contract Number
Not provided
Provider Address
Not provided
Email Address
Not provided
Other Addresses
Not provided

Payment Responsibility

Solely Responsible
Yes
No Reimbursement Confirmed
Yes
Fraud Disclosure Consent
Yes

Financial Details

NHS Percentage
45.00%
Council Demand
Not provided
Bill Payment Method
Monthly instalments
Total Reimbursement Requested
Not provided
Reimbursement Period
Not provided

SBRR Information

SBRR Claimed
No

Supporting Information

NHS % (with evidence)
432.00%
Signature
werwere
Date Signed
Not provided

Submission Details

Submitted Date
02 September 2025 at 11:46
Client IP
213.105.55.130
Application ID
14
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Warning This application contains personal data. Handle in accordance with GDPR and data protection policies.