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Section 1
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User Profile
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| Are you an agent acting on behalf of the applicant?: |
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| Are you: |
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Your Business
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| Is your business registered in the UK with Companies House?:
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| Is your business registered outside the UK?:
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Business Address
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Section 2
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Further Details about the Applicant
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Section 3
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Public Liability Insurance
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| Do you have Public Liability Insurance:
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Directors and Partners
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You must provide details of ALL company directors (if the business is a company), all partners (if it is a partnership), owners of all the business or premises and ALL those responsible for management of the business, including day-to-day management of the premises. Please check local guidance notes and conditions for clarification of exact requirements.
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Does the business have any directors, owners or managers (including owners and day-to-day managers of the premises) in addition to the person named in section one?:
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Section 4
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Previous Refusals
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| Has the applicant, or any person named in this application, ever had a licence refused or revoked?:
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Convictions
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| Has the applicant or any person named in this application been convicted of any criminal offence?:
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Section 5
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Attachments
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Please check local guidance and conditions for any additional information which may be required
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Authority Postal Address
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Declaration
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