Local lockdown restrictions form

Have you been forced to close as a result of Localised (or National) Lockdown Restrictions
Yes – forced to fully closeNo – not forced to close and can continue as normal

What is your Business Rates account number?
Name of Ratepayer

This is the name of the person or company who is liable for Business rates.
Trading Name
Name of person making the application
Capacity of person making the application

Business Owner/Pub Manager/DPS/Employee(Other)
Your email address
Your telephone number
Property Address
Type of business
Bank Details
Please provide Bank details for paying into
Bank Account Name

This is the name of the account holder (ie Mr J Smith) and not the name of the bank.
Sort Code

Just the digits without the dashes
Bank Account Number
I confirm that the applicant has NOT received more than €800,000 (circa £724,000) in state aid during the previous 3 years. This includes business rate relief for retail, leisure and hospitality premises and the business support grants paid earlier in the year by Blackpool Council, and this will also include any COVID19 assistance received from the Government.
I confirm
In completing the below declaration you confirm that you understand that the supply of information, express or implied, which is known to be untrue or misleading may amount to false representation. Accordingly, Blackpool Council or a central government agency may bring proceedings pursuant to the Fraud Act 2006. Such proceedings may result in a criminal conviction.
I confirm