Tobacco Control Act Please print in block letters. If there is insufficient space, attach extra sheets. All applicable questions must be answered and full particulars provided. Application for a Tobacco Retail Licence 1. Type of application This application is for a: Natural person (Sections 2a, 3, 4, 5, 6 and 8 of application) Natural persons in partnership (Sections 2b, 3, 4, 5, 6 and 8 of application) Corporation (Sections 2c, 3, 4, 5, 6, and 8 of application) Association (Sections 2d, 3, 4, 5, 6 and 8 of application) 2a. Applicant details Natural Person – Title Mr Mrs Ms Miss Surname Given name Residential / business address Postal address (all correspondence will be mailed to this address) Telephone Mobile Email 2b. Applicant details Partnership – Full name of each partner (if space is insufficient, please provide information as an attachment) 1. Title Mr Mrs Ms Miss Surname Given name 2. Title Mr Mrs Ms Miss Surname Given name 3. Title Mr Mrs Ms Miss Surname Given name 4. Title Mr Mrs Ms Miss
Tobacco Control Act Please print in block letters. If there is insufficient space, attach extra sheets. All applicable questions must be answered and full particulars provided. Application for a Tobacco Retail Licence 1. Type of application This application is for a: Natural person (Sections 2a, 3, 4, 5, 6 and 8 of application) Natural persons in partnership (Sections 2b, 3, 4, 5, 6 and 8 of application) Corporation (Sections 2c, 3, 4, 5, 6, and 8 of application) Association (Sections 2d, 3, 4, 5, 6 and 8 of application) 2a. Applicant details – Natural Person Title Mr Mrs Ms Miss Surname Given name Residential / business address Postal address (all correspondence will be mailed to this address) Telephone Mobile Email 2b. Applicant details – Partnership Full name of each partner (if space is insufficient, please provide information as an attachment) 1. Title Mr Mrs Ms Miss Surname Given name 2. Title Mr Mrs Ms Miss Surname Given name 3. Title Mr Mrs Ms Miss Surname Given name 4. Title Mr Mrs Ms Miss
application-for-tobacco-licence.docx