Principal or Sole Contractor Statement for Completion
Building Regulation 16 (4A (e))
Application Number (if known)
Site Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Description of work
*
Name
*
Company Name
*
Company Address
*
Street Address
Street Address Line 2
Town
State / Province
Postcode
Phone number
*
Please enter a valid phone number.
Email
*
example@example.com
Appointment Start Date
*
-
Day
-
Month
Year
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Appointment End Date
-
Day
-
Month
Year
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I hereby confirm that I fulfilled my duties as a principal or sole/lead contractor under Part 2A (duty holders and competence) of these Regulations
*
Confirmation
Date
*
-
Day
-
Month
Year
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Submit
Should be Empty: