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Request a Single Person Discount


Please note: Required fields are marked with an asterisk. *

  1. Discount details
    1. Account Number
    2. Date*
      Please specify the date when became sole occupier
    3. Is this the date you moved into the property?
    4. Is this the date you moved into the property?
    5. Have you become the only occupier as someone has moved out?
      If yes, please specify person(s)leaving full name and their forwarding address
    6. Have you become the only occupier as someone has moved out?
    7. Full Name and Address
      Person 1
    8. Full Name and Address
      Person 2
    9. Reason for leaving
    10. Status in your household(i.e. lodger, partner)
    11. Other Circumstances
      Are you applying for the discount due to any other changes in circumstances?
    12. Other Circumstances
    13. If yes, please give more details below
    14. Details
    15. Young Adults
      Are there any members of the household aged 16 or 17?
    16. Young Adults
    17. If yes, please specify their full name and their date of birth
    18. Full Name
    19. Full Name
  2. Your Details
    1. Title
    2. Forename*
    3. Initials
    4. Surname*
    5. Company Name
      If Applicable
    6. Home Phone*
      Please include your area code
    7. Work Phone
      Please include your area code
    8. Mobile Phone
    9. Email Address*
      Please double check this address to ensure it is correct
    10. House Number/Name
    11. Street Name*
    12. Village/Locality
    13. Town/City*
    14. County
    15. Country
    16. Post Code*