TEN Application

Before completing this notice, please read the guidance notes.

The licensing authority will give to you written acknowledgement of the receipt of the notice.
The cost to apply for a TEN is £21.00 and is non-refundable
Fields marked with * are required
I, the proposed premises user, hereby give notice under section 100 of the Licensing Act 2003 of my proposal to carry on a temporary activity at the premises described below
1. The personal details of the premises user
1. Please read note 1.
2. 1. Your name
3. Title*
4. Forenames*
5. Surname*
2. Previous names (Please enter details of any previous names or maiden names, if applicable.)
1. Title
2. Forenames
3. Surname
Another Previous name
1. Title
2. Surname
3. Forenames
Personal Details cont'd
1. 3. Your date of birth (DD/MM/YYYY)*
2. 4. Place of birth*
3. 5. National Insurance Number*
4. 6. Your current address (We will use this address to correspond with you unless you complete the separate correspondence box below)
  1. Address Line 1*
  2. Post town*
  3. Postcode*
7. Other contact details
1. Daytime telephone number*
2. Evening telephone number (optional)
3. Mobile number (optional)
4. Fax number (optional)
5. E-Mail address *
8. Alternative address for correspondence (If you complete the details below, we will use this address to correspond with you)
1. Alternative Address Line 1
2. Post town
3. Postcode
9. Alternative contact details (if applicable)
1. Daytime telephone number
2. Evening telephone number (optional)
3. Mobile number (optional)
4. Fax number (optional)
5. E-Mail address (if available)

Last updated: 06/12/2023 12:13:58

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TEN Application