EH Licensing - Premises Licence

EH Licensing - Premises Licence
I (or We) hereby apply to the Surrey Heath Borough Council, under the Local Government (Miscellaneous Provisions) Act, 1982, for the Registration of the premises occupied by me/us at:
Please select the premises licence type you are applying for:*
Name of Applicant*

First NameLast Name
Are you making a joint application:*
If a joint application is being made, enter the names of all partners:
Business Address (where the activities will be carried out):*

Street Address

Street Address Line 2

Town/CityCounty

Post Code
Email:*
example@example.com
Phone Number:*
Please enter a valid phone number.

Declaration
I/We declare that the information given in this application is to my best knowledge and belief, correct, and understand that a false declaration could result in the registration applied for being revoked.*

Please tick to confirm
Date*

MonthDayYear
The Council will enter the details on its Register. A register of the name of the operator, the name of the business, the address and the type of business carried on at each premises will be open to inspection by the general public. Records of the other information provided will be held by the local authority within the principles of the Data Protection Act 1998 and also may be subject to the Freedom of Information Act 2000. Please see here for further information.
Privacy Statement

Details of Surrey Heath Borough Council’s Privacy Notice can be found here.
By clicking on the 'Submit' button, you will be re-directed to Surrey Heath Borough Council's online payment page to make the appropriate payment. Your Licence will not be issued unless payment is made at application.

If you submit your application to the wrong council, a non-refundable charge of £25 may be applied.
Should be Empty:

Details Of The Premises Being Registered