Request a replacement LA2003 licence Licensing Act 2003 replacement licence request Fields marked with * are required Notification Details Please indicate what you require a replacement for Personal Licence Premises Licence Temporary Event Licence(TEN) Badge Licence Number* Please provide the licence or TEN number Reason for Replacement* Damaged Lost Stolen Any other comments? Your details Name* Email* Contact Telephone Number Are you completing this form on behalf of someone else?* Yes No Assisted service details In what capacity are you completing this form? CC Staff Agent/Solicitor Relative/Friend Carer Other Name of person completing this online form Email of person completing this form Privacy statement Breckland Council is collecting this information, via this form, in order to perform this service or function, and if further information is needed in order to do so, you may be contacted using the details provided. In performing this service, the Council may share your information with other organisations or departments, but only when it is satisfied that it is necessary to perform a public task, or to exercise its statutory duties to do so. The Council may also share your personal information for the purposes of the prevention, investigation, detection, or prosecution of criminal offences, but will not share your personal information, or use it for any other purpose, unless provided for by law. More detailed information about the Council's handling of your personal data can be found in our privacy policy. Payment Name of payee* Payment amount Pay Now Last updated: 22/05/2023 13:40:00