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House and Garage Replacement Rent Payment Card.

This form should only be used for ordering a replacement House or Garage rent payment card (AllPay).

If you became a new Council Tenant within the last 10 days a card will automatically be sent to you.

Name: *

Address: *

Town: *

County: *

Postcode: *

eMail Address *

Telephone Number *

Mobile Number

* indicates required information

Please enter your Rent Account Number for your property:
(If known)

Garage Address:
(If Applicable)