Change name/address on a Personal Licence Fields marked with * are required Please note, before applying to amend your personal licence online, you need to ensure you are changing the information with the Local Authority who originally issued your personal licence. Did Breckland Council issue your original licence?* Yes No No answer You need to contact Local Authority that issued your Personal Licence. I wish to notify the Licensing Team at Breckland Council of* change of name of Personal Licence Holder, fee is £10.50 new address of Personal Licence Holder, Fee is £10.50 Both, fee is £10.50 Change of name Personal Licence Holder previous name Personal Licence Holder new full name Date effective from (DD/MM/YYYY) Reason for change Please upload proof of change of name (for example marriage certificate/deed poll certificate) Permitted file types: JPEG, PNG, PDF. Maximum file size: 2MB Change of address Personal Licence Holder previous address Postcode Personal Licence Holder new address Postcode Date effective from (DD/MM/YYYY) Return licence details I will return the original personal licence * Yes No Please return the personal licence, both the card and paper licence to Licensing Team, Breckland Council, Elizabeth House, Walpole Loke, Dereham, NR19 1EE If you are not able to return the personal licence, please give reasons why not Next Page Last updated: 23/05/2024 12:36:33
