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	*
* indicates required information

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