Your details Your first name Required Your last name Required Contact telephone number Required Your email address Required Your home address Required Postcode Lookup Is this your correspondence address? Required Please Choose Yes No Business name Required Address the business is moving into Required Postcode Lookup Is this your correspondence address Required Please Choose Yes No What date did you purchase the premises/when is your lease dated from? Required From what date are you occupying or going to be occupying the premises? Required Is this a limited company? Required Please Choose Yes No Company registration number If it is a limited company, tell us the company registration number Is this the only business premises you occupy in your name? Required Please Choose Yes No