Licensing General Enquiry Form

Fields marked with * are required
details
1. Name:*
2. Contact telephone number:*
3. Does the resident have an email?*
  
  Yes
  
  No
4. Contact Email:
5. Licence number (if applicable)
6. Premises name (if applicable)
7. Please provide details of your query:*
8. Are you completing this form on behalf of someone else?*
  
  Yes
  
  No
9. Assisted service details
  1. In what capacity are you completing this form?
    
    CC Staff
    
    Agent/Solicitor
    
    Relative/Friend
    
    Carer
    
    Other
  2. Name of person completing this online form
  3. 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.

Last updated: 17/06/2020 15:44:39