Community Infrastructure Levy (CIL)
Form 9: Self Build Residential Extension Exemption Claim Form
Local authority planning application number (if allocated):
Planning Portal Reference (if applicable):
Section A: Claiming Exemption - General Information
To be completed by the individual(s) claiming the exemption.
Please provide the full postal address of the main dwelling (including postcode):
I will establish whether the charging/collecting authority require a Commencement Notice to be
issued prior to commencing my development.
I declare that the amount of de minimis State Aid received in the last 3 years prior to the submission
of this application for relief is less than 200,000 Euro
Please tick ALL boxes
Section B: Self build declaration
Information about de minimis State Aid for the purposes of CIL exemption can be found here:
I understand that my claim for exemption will lapse where development commences prior to the
collecting authority informing me of its decision.
Please complete the form using block capitals and black ink and send to the Charging Authority (or Collecting Authority if this differs from
the Charging Authority).
for guidance on CIL generally, including "relief from the Levy".See
An exemption for a self build extension must be granted prior to the commencement of the development. The applicant will otherwise be
liable for the full levy charge. A Commencement (of development) Notice should also be received by the Charging/Collecting Authority
prior to the date of commencement of the development.
On receipt of this application the collecting authority will make a decision on your claim as soon as practicable and inform the amount of CIL
relief granted in writing.
It is an offence for a person to knowingly or recklessly supply information which is false or misleading in a material respect to a collecting
or charging authority in response to a requirement under the Community Infrastructure Levy Regulations (2010) as amended (regulation
110, SI 2010/948). A person guilty of an offence under this regulation may face unlimited fines, two years imprisonment, or both.
Date (DD/MM/YYYY):Name- Claimant:
I declare that the development is a residential extension within the definition in Regulation 42A(3)
Planning Practice Guidance for CIL