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time
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Please read the Declaration, Data Protection Statement and sign the form before returning.
Declaration
I confirm that the information on the form is true and correct. I undertake to inform Revenues & Benefits within 21 days of any change
in circ
umstances. Failure to provide this information is an offence which may make me liable to an initial fine of £50 and £200 for each
subsequent offence.
Signature of Liable Person___________________________
Date______________
Signature Dat
Email
Address
Day
No.
Data Protection Act and General Data Protection Regulations (“GDPR”)
East Dunbartonshire Council holds, uses and processes information in accordance with the General Data Protection Regulations and
all other relevant national data protection laws. Your information may be shared with other departments within East Dunbartonshire
Council or other organisations for the purposes of administering and collecting council tax and applying relevant reductions, discounts
and exemptions; checking the information we hold is accurate; preventing and/or detecting crime and protecting public funds.
Other organisations may include bodies responsible for auditing or administering public funds or conducting data checks, other
councils, public sector agencies, governmental departments, regulatory and law enforcement bodies and other private companies or
entities (such as credit reference agencies, service providers/contractors and/or partner bodies).
For further information detailing how East Dunbartonshire holds and uses your information please refer to the privacy notice enclosed
with this form. Details are also available on our website at: http://www.eastdunbarton.gov.uk/counciltax
Other Formats & Translations
This document can be provided in large print, Braille or on CD and can be translated into other
community languages. Please contact the Council’s Corporate Communications Team at 12
Strathkelvin Place, Kirkintilloch, G66 1TJ, tel 0300 123 4510
Page 2 of 2
Please return to: Revenues & Benefits, East Dunbartonshire Council,
William Patrick Library, 2/4 West High Street, Kirkintilloch G66 1AD
Telephone: 0141 578 8190 Email: counciltax@eastdunbarton.gov.uk
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