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<!DOCTYPE html PUBLIC "-//W3C//Dtd HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"><html lang="en"> <head> <meta http-equiv="Content-Type" content="text/html; charset=utf-8"></head> <body> <div style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Thank you for your request.</div><div style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Please find details of your submission below:</div><br><div style="display: inline;" class="DocumentTitleBackground"><h1 style="display: inline;" style="display: inline; font-family: Arial, Verdana, Sans-Serif; font-size: medium; color: #333333">Local Land Charges Register Search Service - Ref. 21651740<br></h1></div><hr style="height: 1px; color:#0080C0;" noshade="noshade"><table summary="layout table" border="0" cellpadding="8" cellspacing="0" width="100%"> <tr><td><table summary="layout table" border="0" cellspacing="8" cellpadding="0" style="background-color: #f4f9ff; color: #333333; border: 1px solid #999999;" width="100%"> <tr><td colspan="2" align="left" valign="top"><div style="display:inline" class="SectionTitleBackground"><h2 style="display: inline;" style="display: inline; font-family: Arial, Verdana, Sans-Serif; font-size: medium; color: #000099">Applicant</h2></div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Organisation name</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Search Acumen</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Any other name you may be known by</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Search Acumen</div></td></tr> <tr><td align="left" width="50%" valign="top"></td><td align="left" width="50%" valign="top"></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Address Ref.</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">5128351</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Address</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">The Maidstone Studios <br>New Cut Road</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Town</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Maidstone</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>County</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Kent</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Postcode</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">ME14 5NZ</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Email address</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><a href="mailto:searchorders@search-acumen.co.uk?subject=Local+Land+Charges+Register+Search+Service-21651740" title="searchorders@search-acumen.co.uk (opens a new window)" onmouseover="window.status=blank; return true;" onmouseout="window.status=blank; return true;" target="_blank">searchorders@search-acumen.co.uk</a> </div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Phone</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">08002404746</div></td></tr> </table><br> <table summary="layout table" border="0" cellspacing="8" cellpadding="0" style="background-color: #f4f9ff; color: #333333; border: 1px solid #999999;" width="100%"> <tr><td colspan="2" align="left" valign="top"><div style="display:inline" class="SectionTitleBackground"><h2 style="display: inline;" style="display: inline; font-family: Arial, Verdana, Sans-Serif; font-size: medium; color: #000099">Select Address(es)</h2></div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Postcode</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">NW3 4BN</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>UPRN</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">5084875</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Address</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Flat 1<br>The Porticos<br>53-59 Belsize Avenue<br>London<br>NW3 4BN</div></td></tr> <tr><td colspan="2" width="100%"><hr style="height: 1px; color:#0080C0;" noshade="noshade"></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><strong><em> No of addresses</em></strong></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">1</div></td></tr> </table><br> <table summary="layout table" border="0" cellspacing="8" cellpadding="0" style="background-color: #f4f9ff; color: #333333; border: 1px solid #999999;" width="100%"> <tr><td colspan="2" align="left" valign="top"><div style="display:inline" class="SectionTitleBackground"><h2 style="display: inline;" style="display: inline; font-family: Arial, Verdana, Sans-Serif; font-size: medium; color: #000099">Site details</h2></div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Site details</em></div></td><td align="left" width="50%" valign="top"></td></tr> </table><br> <table summary="layout table" border="0" cellspacing="8" cellpadding="0" style="background-color: #f4f9ff; color: #333333; border: 1px solid #999999;" width="100%"> <tr><td colspan="2" align="left" valign="top"><div style="display:inline" class="SectionTitleBackground"><h2 style="display: inline;" style="display: inline; font-family: Arial, Verdana, Sans-Serif; font-size: medium; color: #000099">Select search(es)</h2></div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>No of properties</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">1</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>LLC1</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Yes</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>CON29R</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Yes</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>CON29O</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Yes</div></td></tr> </table><br> <table summary="layout table" border="0" cellspacing="8" cellpadding="0" style="background-color: #f4f9ff; color: #333333; border: 1px solid #999999;" width="100%"> <tr><td colspan="2" align="left" valign="top"><div style="display:inline" class="SectionTitleBackground"><h2 style="display: inline;" style="display: inline; font-family: Arial, Verdana, Sans-Serif; font-size: medium; color: #000099">Con 29 optional questions</h2></div></td></tr> <tr><td align="left" width="50%" valign="top"></td><td align="left" width="50%" valign="top"></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>4. Road Proposals by Private Bodies</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>5. Advertisements</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>6. Completion Notices</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Yes</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>7. Parks and countryside</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>8. Pipelines</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>9. Houses in multiple occupation</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>10. Noise abatement</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Yes</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>11. Urban development areas</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>12. Enterprise Zones, Local Development Orders & Bids</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>13. Inner urban improvement areas</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>14. Simplified planning zones</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>15. Land maintenance notices</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>16. Mineral Consultation and Safeguarding Areas</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>17. Hazardous Substance Consents</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>18. Environmental and Pollution Notices</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>19. Food Safety Notices</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>20. Hedgerow Notices</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>21. Flood Defence and Land Drainage Consents</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">No</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>22. Common land, town and village greens</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Yes</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>No. of Con29O questions</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">3</div></td></tr> </table><br> <table summary="layout table" border="0" cellspacing="8" cellpadding="0" style="background-color: #f4f9ff; color: #333333; border: 1px solid #999999;" width="100%"> <tr><td colspan="2" align="left" valign="top"><div style="display:inline" class="SectionTitleBackground"><h2 style="display: inline;" style="display: inline; font-family: Arial, Verdana, Sans-Serif; font-size: medium; color: #000099">Charges</h2></div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>LLC1 chargeable properties</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">1</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>LLC1 Charge</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">40.00</div></td></tr> <tr><td align="left" width="50%" valign="top"></td><td align="left" width="50%" valign="top"></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Con29R chargeable properties</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">1</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Con29R charge</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">90.00</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em><b><i><strong>*This will be the VAT added to total </b></i></em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">18.00</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>No. of Con29O questions</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">3</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Con29O charge</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">56.49</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em><b><i><strong>*This will be the VAT added to total </b></i></em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">11.30</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>No. of Con29 additional questions</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">0</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Con 29 additional questions charge</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">0.00</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em><b><i><strong>*This will be the VAT added to total </b></i></em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">0.00</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Total Charge</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">215.79</div></td></tr> </table><br> <table summary="layout table" border="0" cellspacing="8" cellpadding="0" style="background-color: #f4f9ff; color: #333333; border: 1px solid #999999;" width="100%"> <tr><td colspan="2" align="left" valign="top"><div style="display:inline" class="SectionTitleBackground"><h2 style="display: inline;" style="display: inline; font-family: Arial, Verdana, Sans-Serif; font-size: medium; color: #000099">Documents attached</h2></div></td></tr> <tr><td width="100%" colspan="2" align="left" valign="top"><div><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><a href="https://forms.camden.gov.uk/cus/servlet/ep.getImg?ref=13963821018&print=Y&st=&auth=205" title="plan (opens a new window)" onmouseover="window.status=blank; return true;" onmouseout="window.status=blank; return true;" target="_blank">plan</a></div></div></td></tr> </table><br> <table summary="layout table" border="0" cellspacing="8" cellpadding="0" style="background-color: #f4f9ff; color: #333333; border: 1px solid #999999;" width="100%"> <tr><td colspan="2" align="left" valign="top"><div style="display:inline" class="SectionTitleBackground"><h2 style="display: inline;" style="display: inline; font-family: Arial, Verdana, Sans-Serif; font-size: medium; color: #000099">About this form</h2></div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Issued by</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Contact Camden<br>5 Pancras Square<br>London N1C 4AG</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Received on</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">13/01/2021</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Form reference</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">21651740</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Contact method</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Form</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Amount paid</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">�215.79</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Payment method</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">Credit Card</div></td></tr> <tr><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333"><em>Authorisation code</em></div></td><td align="left" width="50%" valign="top"><div style="display: inline;" style="font-family: Arial, Verdana, Sans-Serif; font-size: small; color: #333333">P0003634522</div></td></tr> </table><br> </td></tr></table> </body> </html>
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