Interim authority notice under the Licensing Act 2003

Progress

Before you begin

This form can be completed and submitted by the applicant, or the applicant’s agent (for example, solicitor), providing they have authority to do so.

Guidance notes

Contact details for correspondence

Enter a point of contact for this application. This is where we will send all correspondence, including payment information.

Are you an agent acting on behalf of the applicant?

Agent signatory details

If you have authority to complete the form on behalf of the applicant, verify in what capacity, for example, solicitor.

If this is a joint application, add details of the second applicant’s authorised agent.

Add signatory

Applicant signatory details

If this is a joint application, add the second applicant below.

Add signatory

I/we give this interim authority notice under section 47 of the Licensing Act 2003 for the premises described in this application.

Premises details

Premises address

Can you provide a postal address, OS map reference or description of the premises?
Address
 

Premises contact details

Details of notice giver

Individual notice givers
Age confirmation
Current postal address if different from the premises address (optional)
 

Use the Lookup Postcode button to find the address.

If you cannot find the address, please enter it manually

What is your date of birth?

Right to work in the UK

All individuals must prove they have a right to work in the UK and are not subject to any condition preventing them from doing work relating to the licensable activity. You can provide a copy of your passport photo page or similar proof, or you can use the Home Office online right to work checking service to access your share code.

This can be a copy of your passport photo page or other accepted proof. To upload multiple files, hold 'Ctrl' (Windows) or 'Cmd' (Mac) when choosing files to upload.

Is there a second individual notice giver?

Second individual notice giver
Age confirmation
Current postal address if different from the premises address (optional)
 

Use the Lookup Postcode button to find the address.

If you cannot find the address, please enter it manually

What is your date of birth?

Right to work in the UK

All individuals must prove they have a right to work in the UK and are not subject to any condition preventing them from doing work relating to the licensable activity. You can provide a copy of your passport photo page or similar proof, or you can use the Home Office online right to work checking service to access your share code.

This can be a copy of your passport photo page or other accepted proof. To upload multiple files, hold 'Ctrl' (Windows) or 'Cmd' (Mac) when choosing files to upload.

Non-individual notice givers

(for example, partnership, company, unincorporated association etc)

Address
 

Use the Lookup Postcode button to find the address.

If you cannot find the address, please enter it manually

Partnerships and joint ventures

In the case of a partnership or joint venture (other than a body corporate), you must give the name and address of each party concerned.

Does a partnership or joint venture (other than a body corporate) apply to this application?

Details of partnership or joint venture

Address of party
 

Use the Lookup Postcode button to find the address.

If you cannot find the address, please enter it manually

To add details of another party, click 'Add party'.

Add party

Further information
Has an interim authority notice previously been given relating to this premises and the former premises licence holder?
Has there been an application to transfer the premises licence under section 50 of the Licensing Act 2003?

Declaration

I/We understand that it is an offence, under section 158 of the Licensing Act 2003, to make a false statement in or in connection with this application. Those who make a false statement may be liable on summary conviction to a fine of any amount.

It is an offence under section 24b of the Immigration Act 1971 for a person to work when they know, or have reasonable cause to believe, that they are disqualified from doing so by reason of their immigration status. Those who employ an adult without leave or who is subject to conditions as to employment, will be liable for a civil penalty under section 15 of the Immigration, Asylum and Nationality Act 2006 and, pursuant to Section 21 of the same act, will be committing an offence where they do so in the knowledge, or with reasonable cause to believe, that the employee is disqualified.

Individual notice givers: I understand I am not entitled to be issued with a licence if I do not have the entitlement to live and work in the UK (or if i am subject to a condition preventing me from doing work relating to the carrying on of a licensable activity) and that my licence will become invalid if I cease to be entitled to live and work in the UK. I have included documents or a Home Office share code, demonstrating my entitlement to work in the UK.

  • I have read and understand the above declaration.
  • I have notified the designated premises supervisor (if different from the premises licence holder), if any.
  • I confirm that I am entitled to work in the UK.
Confirmation

Before you submit this form please review your answers below. If you need to change anything, use the 'previous' button on the bottom left to go back to a section. Then submit the form by selecting the 'Submit button' at the bottom of this page