Notification of Change of Address- Designated Premises Supervisor

Change of Address

Licensing Act 2003 Premises Licence- Notification of Change of Address of Desiganted Premises Supervisor.

After completing this form, please can you send your Premises Licence and Summary to:

Environmental Health and Licensing
The Gateway
Gatehouse Road
Aylesbury
Buckinghamshire
HP19 8FF

Premises Details
Full Name of Designated Premises Supervisor
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Previous Address
New Address

By choosing submit you are confirming that the information contained in this form is correct to the best of your knowledge and belief.
You will then be taken to the council's payment system to make your payment of £10.50.