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Housing Rents Payment

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Payment details
* = Required information
Housing Rents reference:	*
Amount to pay:	*  e.g. 10.00
Name (as it appears on your card):	*
House number and/or name:	*
Postal code:	*
E-mail address:	*  e.g. john.smith@internet.com
Telephone number:	*  e.g. 01824 706101