Notification of an interest in premises under section 178 of 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 details of the second applicant below.

Add signatory

Details of notifier

I/We as named above give notice of my/our interest in the premises identified in this application for the purposes of section 178 of the Licensing Act 2003.

Premises details

Premises address

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

Use the Lookup Postcode button to find the address.

If you cannot find the address, please enter it manually

Licence holder

Details of interest in the premises
I/We
I/We are

Details of individual
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

Is there a second individual notice giver?

Second individual notifier
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

Details of non-individual

If your organisation is registered with Companies House, you must enter the number here. If you are not registered with Companies House, enter ‘Does not apply’.

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

Company 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

If you wish to add details of additional parties, select 'Add party'.
Address of party
 

Use the Lookup Postcode button to find the address.

If you cannot find the address, please enter it manually

Add party

Declaration

I/We understand 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.

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