HILLINGDON Mr Aswin Subhash Property Ref: 870702907 60 Verona Close Enquiries To: Council Tax Collection Cowley Uxbridge Date: 13th October 2021 Middx ‘UBS 2LL [COUNCIL TAX REGISTRATION FORM] YOU ARE REQUIRED BY LAW TO COMPLETE SECTIONS 1 OR 2, 3 AND 9 AND RETURN THIS FORM WITHIN 21 DAYS TO: LB Hillingdon Revenues & Benefits Services, PO Box 1120, 1 Market Street, Nelson, Lancs BB9 7LJ or via email to Counciltax@Hillingdon.gov.uk. Failure to do so, or knowingly supply false information, may result in a PENALTY of at least £50 being imposed against you. Hillingdon Council processes data in line with its obligations under data protection legislation, for more information on how your data is processed please visit, www hillingdon.gov.uk/privacy. The information in SECTIONS 1 or 2 and 3 below is required to ensure the correct amount of Council Tax is charged to the liable person(s). Please USE BLOCK CAPITALS, where necessary. ECTION 1 - OCCUPIED PROPERTIES: ) Please enter the name(s) of ALL the OWNER(S) or TENANT(S) (18 or over) who live in the roper Tite Forename(s) Surname Date Previous Address ‘Occupied Re | ASN ee RT ree [18/09/2081] PIRA-33 ERWAKuLAM, KERALA, INDIA, PM:6EX MS | NEENU [CHANDRAMDHAN [\8/09/a0ai| 13-E, SEYUNE ERNAKULAM, KERALA, INDIA, 68230) elope] =| B) Please indicate the residence status of those listed above, using the examples below: - OWNER / LEASEHOLDER / TENANT / OTHER (Please specify) Myou are a tenantlleaseholder, please enclose your signed agreement. Aocrenrntr 2. TENANT ¢ mnie a ‘SECTION 2 - UNOCCUPIED PROPERTIES: C) If the property is NOT occupied by anyone as their sole or main residence please complete this section: Name & Address of ii) Their status OWNER/ TENANT Owner or Tenant or LEASEHOLDER Leaseholder ill) Is the property FURNISHED UNFURNISHED ‘SECTION 3 - OTHER DETAILS OF OWNERSHIP (or LEASE or TENANCY) ("delete as D) ae ETION* or Date Date LEASE* or TENANCY* Date of COMPLI or LEASE* or TENANCY* 04 [09/2021 expires 03 [or [208 ‘commenced E) Name, address and telephone number of any Solicitor who acted for you (you do not have to rovide this but itis helpful if you do)Sections 4 - 7 relate to certain discounts and reliefs. Please complete any section(s) that may be applicable to you. Please complete section 8 confirming how you wish to pay your Council Tax. Section 9 must be completed in all cases. SECTION 4 - SINGLE PERSON HOUSEHOLD (1 ADULT) G) If you live ALONE - please tick this box (please IGNORE children under 18 years of age) H) Please enter the name(s) and date(s) of birth of those children who will become 18 years of age within the NEXT 24 months (eldest first) FULL NAME(S) DATE(S) OF BIRTH ‘SECTION 5 - STUDENTS AND OTHER TYPES OF DISCOUNTS - (Relevant codes can be found at www.hillingdon.gov.uk/Council-tax-disregards-and-occupled-annexes) 1) Please state how many ADULTS (aged 18 or over) live in the property as their mainhome [2 J) Now please state how many of those adults in 1) are:~ i) Students 2 CODE NO or ii) Other Types 4 CODE NO OL ‘SECTION 6 - DISABLED PERSON RELIEF ) If any people living in the property are DISABLED (including any disabled children) and the property has certain facilities for meeting their needs, please tick this box { SECTION 7 - COUNCIL TAX REDUCTION SCHEME (Rebate) IL) If you are on a low income and wish to apply for a Council Tax Reduction, please go to ‘www hillingdon.gov.uk/ctrapply. Please note: If you have been placed here by another Council who are paying your Housing Benefit you must apply to Hillingdon Council for Council Tax Reduction. ‘SECTION 8 - PAYING COUNCIL TAX - Direct Debit, Post Office, Bank Giro Credit 'M) Please tick the appropriate box to select your METHOD OF PAYMENT & the NUMBER OF PAYMENTS (Note monthly instalments cannot be granted after 1st January for the year ending 31st March s METHOD OF PAYMENT li) NUMBER OF PAYMENTS Direct Debit - (Please also Monthly / complete & return the enclosed instruction) or Payment card or 2 half yearly payments or ‘One annual payment SECTION 9 - DECLARATION declare that the information provided on this form is true, complete and accurate to the best of my knowledge SIGNED Ss DATE 20/10/2021 PRINT FULL NAME_ASWIN PUTHUKKATTU SURHASH TEL No: Daytime Evening, Mobile__03563082396 |Are you happy to receive SMS text alerts from the Council (delete as appropriate): Yes /Ne- EMAIL ADDRESS: AS WINPS93 @ GMAIL: CoM