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Licence Application Forms

The following Applications Forms are available for downloading:-

 
LA3 - Application to Renew a Personal License
 
LA4 - Application for a Premises License
 
LA5 - Application for a Provisional Statement to be Granted
 
LA6 - Application for Review or Club Premises Certificate
 
LA7 - Application to Transfer Premises License
 
LA8 - Notification of Interest in Premises
 
LA9 - Declaration for a Club Premises Certificate
 
LA10 - Application for an Existing License to Convert to a Premises License
 
LA11 - Application For a Personal License
 
LA12 - Interim Authority Notice
 
LA13 - Application to Vary a Premises License to Specify an Individual as the Designated Premises Supervisor
 
LA14 - Application to Vary a Club Premises Certificate
 
LA15 - Application to Vary a Premises License
 
LA16 - Application for a Club Premises Certificate
 
LA17 - Application Process - Premises License
 
LA18 - Disclosure of Convictions and Declaration
 
LA46 - Application for a Temporary Event Notice
 
LA57 - Representation Made in Respect of a New Grant or Variation of a Club Premises Licence or Club Premises Certificate 
 

Contact Information

 
Completed application forms together with the relevant documents and fee should be returned either in person or by post to the Licensing Section.

Downloads
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Licensing Doc 1  (47.9 KB)
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Licensing doc 2  (118 KB)
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Licensing doc 3  (111 KB)
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Licensing doc 9  (54.4 KB)
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licensing doc 10  (56.8 KB)
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Licensing doc 11  (46.4 KB)
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Licensing doc 13  (104 KB)
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Licensing doc 15  (20.4 KB)
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Licensing doc 16  (45.4 KB)
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Representation made in respect of a new grant or variation of a premises licence or club premises certificate  (11.3 KB)
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Temporary Event Notice  (57.2 KB)
Contact Details
Licensing Team

Council House Saltergate Chesterfield S40 1LF

Telephone: 01246 217216
Fax: 01246 217447
Text Us: 0780 0002425
Contact Us: Enquiry Form

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