## Authorisation  Please Use Capital Letters

I am a partner within the partnership named above and I understand that HM Revenue & Customs
(HMRC), in dealing with the partnership's application to have its Construction Industry Scheme payments paid gross, will consider whether the partners have complied with the conditions set out at Paragraph 4, Part 1, Schedule 11, Finance Act 2004.

If HMRC are of the opinion that I have not complied with all the conditions set out at Paragraph 4, Part 1, Schedule 11, Finance Act 2004, I authorise HMRC to disclose this to the registering partner.

I understand that HMRC may refer to any of my failures to fulfil the conditions in any appeal proceedings before the Tribunal. I authorise HMRC to do this.

Partner's name Partner's Unique Tax Reference (UTR)
National Insurance number Partnership Unique Tax Reference (UTR)