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Severely Mentally Impaired Disregard form

Details of the council taxpayer and property to which the disregard relates
1. Customer details layout
  2. Your details
    
    First name*
    
    Surname*
    
    USERPROFILEADDRESS
    
    Address
    
    Find Address
    
    Enter a postcode*
    
    Please enter a postcode and select Find address
    
    Sorry, no address found for this postcode.
    Please check and retry a new postcode, or fill in the address details below
    
    Address
    
    CURRENTADDRESS
    
    Address
    
    Address
    
    Postcode
    
    Enter Address
    
    House or flat number
    
    Building name (optional)
    
    Street
    
    City or Town
    
    Postcode
    
    ADDRESSTEXTFINAL - USE THIS IN TEMPLATES
    
    ADDRESSPOSTCODE
    
    Email
    
    Phone Number*
    Include your area code when providing landline numbers
2. Council Tax account reference*