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Licensing Review form

Before completing this form please read the guidance notes

Before completing this form, please read the guidance notes.
Application to review a premises licence under the Licensing Act 2003
Fields marked with * are required
Review Application
1. I (applicant name)*
2. apply for the review of*
  
  a premises licence under section 51 of the Licensing Act 2003
  
  a club premises certificate under section 87 of the Licensing Act 2003
3. for the premises described in Part 1 below
Part 1
1. Premises or club details - Postal address of premises or, if none, ordnance survey map reference or description
2. Name of Premises or Club*
3. Postal Address*
4. Post town*
5. Post code (if known)
6. Name of premises licence holder or club holding club premises certificate (if known)
7. Number of premises licence or club premises certificate (if known)