Rent Refund Form

Please provide the following details which can be found on the payment receipt from LBH:
1. PLEASE ALLOW UPTO 6 WEEKS FOR YOUR REQUEST TO BE PROCESSED.
  PLEASE NOTE - If the tenancy is a joint tenancy, both tenants must sign the form.
2. Tenant(s) Name
3. Rent Reference Number
4. Contact Telephone No (optional)
5. Tenancy address
  1. Postcode
    
    Address
6. Label
  2. Address
  3. (optional)
  4. (optional)
  5. Town
  6. Postcode
7. Requested Refund Amount (£) (optional)
8. Name of Bank
9. Name(s) of Account Holder(s)
10. Sort Code
11. Account Number
Label
1. Email address for receipt of request
Declaration
1. - I understand that the refund amount may be amended in certain circumstances.
  
  - Where an alternative payee has been nominated, I understand that I am responsible for the information I have provided.
2. Tenant 1 - Printed Name
3. Tenant 2 - Printed Name (optional)
4. Date
  
  Day
  
  Month
  
  Year