ef240635 - formulario de reclamo

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Page 1: EF240635 - Formulario de Reclamo

Council tax - General correspondence

page 1 of 2

23/08/2013 Council tax - General correspondence Ref No. EF240635

Your details

Please provide your name and address:

Title Mrs

First name Margarita eugenia

Last name Perez Rodriguez

Address 1 FLAT 65

Address 2 VANILLA AND SESAME COURT CURLEW STREET

Address 3

Postcode SE1 2NN

Please confirm the following:

Your council taxaccount number

49007072

Please provide contact details:

Telephone (44) 2073118529

Email [email protected]

IaWUserId EFORMS

FileSystemDocClass RE

________________________________________________________________________________________

Your reasons for contact

Please tell us why you are contacting us:

Reason for contact I received a payment warning. I control my payments and I detected an error in mydirect debit. I paid 176 pounds the day August 19 (basket reference number 000 934551). the subsequent days I'm controlling my payments online and I noticed that theyhave not yet processed my online payment. Please let me know the status of it.

Do you want to attach documents with your correspondence?

Please choose Yes

_______________________________________________________________________________________

Page 2: EF240635 - Formulario de Reclamo

Council tax - General correspondence

page 2 of 2

Attach documents

Attach scanned or saved documents: - First Entry

London Borough of Southwark Payment Receipt.pdf

_______________________________________________________________________________________

Declaration

I confirm that the information provided in this form is true and correct to the best of my knowledge and belief.

I understand that a minimum £70 penalty can be imposed, or I may be prosecuted, if any information given inthis form is found to be untrue.

Under the provisions of Regulation 3 of the Council Tax (Administration and Enforcement) Regulations 1992, ifyou fail to supply information requested of you within 21 days you may be subject to a penalty of £70.

I have read and agree to the above declaration:

Agree declaration Agree

DocType CCOR

_______________________________________________________________________________________

The information you provide will be used fairly and lawfully and Southwark Council will not knowingly doanything which may lead to a breach of the Data Protection Act 1998.