Submit Revaluation Information Form

1. Occupiers details

🛈 Please tick this box where occupier details have changed, including where recipient of this form no longer occupies the subject property, proceed to Section 11 and enter details *

A. Occupier Name (Owner Name where owner is occupier):*

B. Trading Name:

C. Companies Registration Office number (where relevant – more information can be found at www.cro.ie):

Autocomplete Eircode:

D. Eircode (of subject property): *

E. Telephone Number:*

F. Email Address:

2. Ownership of premises

Do you own these premises? *

Yes

If "Yes", and you purchased the premises within the past five years, please give:

Date Of Purchase (MM/YY):

Purchase Price: €

Where there is a tenancy or rental agreement please fill in Sections 3 to 9

Where the property is held freehold please go to Section 10

10. Property details:

A. Please give details of property use:
(eg shop, restaurant, factory, warehouse etc)

B. Name of managing agent (if any – Information available at www.psr.ie/en/PSRA/Pages/Register_Licensed_PSP):

C. Management Agent Number:

11. If you want to give any additional information specific to your property, not captured in questions 1-10, please provide below:

12. I confirm that to the best of my knowledge, the above information is correct:

By clicking the Submit Revaluation Information button below you are confirming that the above information is correct

Full Name:*

Position (e.g. Occupier, Company Director, etc):*

Your Email (Receipt will be emailed to this address)*