I declare that my circumstances and the information provided below are, to the best of my knowledge, true and accurate. I understand that supplying false information will result in the discount being removed. In addition, if my circumstances change I will immediately notify Dacorum Borough Council. I understand that it is a criminal offence for a ratepayer to give false information when making an application for small business rate relief. I understand that the information I provide will be used in accordance with the law to protect public funds.