Application forms - Licensing Act 2003

Below is a guide to which application forms you will need to obtain your licence.

Under the heading of each licence type are several links which you can use to download the relevant forms.

Please note that you will need to complete all of the forms (in PDF or Word format) listed below the licence type. You do not have to complete the checklists or guidance notes, these are for your benefit.

To use PDF forms: Print off the relevant form and fill in manually

To Use Word forms: Select the relevant form and save to a file on your personal computer. This form can be filled in electronically and then printed off, signed and returned to the licensing team.

**PLEASE NOTE: Some of these forms are in the process of being updated and are currently unavailable.**

Application for a Personal Licence

Personal licence checklist ( PDF File 22KB file details)
LA117A Application for a Personal Licence ( PDF File 23KB file details)
LA117A Application for a Personal Licence ( WordPad Document 97K file details)
LA117D Disclosure of convictions and declaration ( PDF 29K file details)
LA117D Disclosure of convictions and declaration ( WordPad Document 51K file details)

If you would like a hard copy of the above forms sent to you please telephone 01732 227000.

Application for a Premises Licence

LA 17 new premises application form ( Wordpad Document 589KB file details)
LA 17 new premises application form ( PDF File 414KB file details)
LA37(3) Consent to be premises supervisor ( PDF 18K file details)
LA37(3) Consent to be premises supervisor ( WordPad Document 38K file details)
LA57-3 Notice specifying the position held ( PDF 19K file details)
LA57-3 Notice specifying the position held ( WordPad Document 25K file details)
LA 29 application form for provisional statement ( Wordpad Document 584KB file details)
LA 29 application form for provisional statement ( PDF File 406KB file details)

Application to vary an existing Premises Licence

LA 34 Application to vary premises licence ( Wordpad Document 387KB file details)
LA34 Vary a premises licence DCMS ( PDF 152K file details)
Minor variation application form ( Wordpad Document 123KB file details)
Minor variation notes ( Wordpad Document 66KB file details)
Designated premises supervisor - Variation of mandatory condition ( PDF File 75KB file details)
DPS Mandatory Condition notes ( Wordpad Document 112KB file details)

Application to vary a Premises Licence - Designated Premises Supervisor

LA 37 Application for a variation of the designated premises supervisor ( Wordpad Document 74KB file details)
LA37 Vary the Premises Supervisor DCMS ( PDF 51K file details)
LA37(3) Consent to be premises supervisor ( WordPad Document 38K file details)
LA37(3) Consent to be premises supervisor ( PDF 18K file details)
LA 41-1 Request to be removed as designated premises supervisor ( Wordpad Document 36KB file details)
LA41-1 Request to be removed as DPS ( PDF File 12KB file details)

Application to transfer a Premises Licence

LA 42 application form to transfer premises licence ( Wordpad Document 160KB file details)
LA 42 application form to transfer premises licence ( PDF File 126KB file details)
LA 44(4)B - Consent to transfer Premises Licence ( Wordpad Document 28KB file details)
LA44-4B Consent of licence holder to transfer DCMS ( PDF 21K file details)
LA 47 Interim authority notice ( Wordpad Document 145KB file details)
LA 47 Interim authority notice ( PDF File 129KB file details)
LA43-5 Steps taken to obtain consent ( PDF File 21KB file details)

Application to review the Premises Licence

LA 51 Application to review a premises licence ( Wordpad Document 110KB file details)
LA51-87 Review of licence DCMS ( PDF 56K file details)
Understanding the review process - notes ( Wordpad Document 68KB file details)

Other documents relating to Premises Licences

LA33 Notification of change of name or address ( PDF 94K file details)
LA25 Copy of premises licence or summary ( PDF 9K file details)
LA28 Notice of surrender of premises licence ( PDF File 15KB file details)
LA178 Notification of interest in premises DCMS ( PDF 65K file details)

Application for a Club Premises Certificate

LA61 Declaration of club premises certificate ( PDF 42K file details)
LA61Declaration of club premises certificate ( WordPad Document 63K file details)
LA61 Addenda Guidance Notes ( PDF 82K file details)
LA94-4 Notice of nominated person and summary ( PDF 18K file details)
LA71 Application for club premises certificate( ( WordPad Document 360K file details)
LA71 Application for club premises certificate ( PDF 119K file details)

Temporary Event Notices

Temporary Event Notice ( Wordpad Document 188KB file details
Temporary Event Notice ( PDF File 102KB file details)
Temporary Event Notice Info and FAQ's ( PDF File 65KB file details)
(Please download this information which contains important details to ensure you send in a valid Temporary Event Notice.)

If you would like a hard copy of the above forms sent to you please telephone 01732 227004.

There are other forms available which should be filled in in other situations. Below are links to all of the forms which may be relevant to you.

Personal Licence Forms