Version 2019
Checklist
This completed form should be accompanied by:
a) A plan which identifies the relevant land, buildings in
use on that land and any of those buildings which are to
be demolished;
b) Photographic evidence of buildings in use on the
relevant land;
c) A plan which identifies the chargeable development;
Your local authority may request any other plans, drawings and information necessary to describe any buildings in use on the relevant
land and the chargeable development. Any plans or drawings required must be drawn to an identified scale and, in the case of plans, shall
show the direction of North.
Declaration - Notice of Chargeable Development - Landowner
I/we confirm that the information above is correct to the best of my/our knowledge, and I/we am/are aware of the consequences of
providing incorrect information, including regarding the demolition or change of use of buildings. I/we confirm I/we have assumed
liability through the relevant section of this form and that, if not, I/we will submit an assumption of liability notice. I/we understand that I/
we must submit a commencement notice in order to secure the 60 day payment window or such time as the charging authority has
allowed in its current payment instalments policy, as per the requirements of the Community Infrastructure Levy Regulations (2010) as
amended. I/we undertake to notify the collecting authority in writing of any changes to the information on this notice, prior to this
development commencing. I/we understand any communication and actions by the collecting authority to pursue me/us for the
assumed liability will be copied to the site land owners (as defined in CIL regulations)
Name - Landowner:
Date (DD/MM/YYYY):
It is an offence for a person to knowingly or recklessly supply information which is false or misleading in a material respect to a charging or
collecting 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.
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Supporting Information
Has a building, or a part of a building, on the site been in lawful use for a
continuous period of at least 6 months within the past 36 months?
If Yes, please state how much gross internal floorspace you propose to
demolish (square metres):
Yes No
Or change of use (square metres):
Please set out the intended use of the chargeable development and the intended floorspace of each use
Intended Use (please detail each use proposed) Gross internal new build floorspace of each intended use (sq m)