Part 1 - Details of Interested Parties 1 The Applicant(s) Name(s): Residential Address(es): Business Address(es): Telephone(s): Email Address(es): Date of birth: The applicant(s) is/are also: The proposed licence holder(s): Yes No Official The person(s) managing the property: Yes No use The person(s) having control of the property: Yes No The Yes No The leaseholder Yes No freeholder: 2 The Proposed Licence Holder (if not the applicant) Name(s): Residential Address(es): Business Address(es): Telephone(s): Email Address(es): Date of birth: The proposed licence holder is/are also: The person(s) managing the property: Yes No The person(s) having control of the property: Yes No Official use The Yes No The leaseholder: Yes No freeholder: All information above is to be duplicated in section 10 3 The Proposed Manager of the property (if not applicant or licence holder) Name(s): Residential Address(es): Business Address(es): Telephone(s): Email Address(es): Date of birth: Official use Is the manager also the person having control of the Yes No property: All information above is to be duplicated in section 10
Part 1 - Details of Interested Parties 1 Official use The Applicant(s) Name(s): Residential Address(es): Business Address(es): Telephone(s): Email Address(es): Date of birth: The applicant(s) is/are also: The proposed licence holder(s): Yes No The person(s) managing the property: Yes No The person(s) having control of the property: Yes No The freeholder: Yes No The leaseholder Yes No 2 Official use The Proposed Licence Holder (if not the applicant) Name(s): Residential Address(es): Business Address(es): Telephone(s): Email Address(es): Date of birth: The proposed licence holder is/are also: The person(s) managing the property: Yes No The person(s) having control of the property: Yes No The freeholder: Yes No The leaseholder: Yes No All information above is to be duplicated in section 10 3 Official use The Proposed Manager of the property (if not applicant or licence holder) Name(s): Residential Address(es): Business Address(es): Telephone(s): Email Address(es): Date of birth: Is the manager also the person having control of the property: Yes No All information above is to be duplicated in section 10
Selective%20Licence%20Application%20LAC.docx