Application for Variation of Premises Licence

Premises Licence Details

Licence Number of Premises *

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Name of Premises *

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Address of Premises *

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Postcode of Premises *

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Premises Manager Details

Full Name of Premises Manager *

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Address of Premises Manager *

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Postcode of Premises Manager *

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Date of Birth of Premises Manager *

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Email Address of Premises Manager *

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Contact number of Premises Manager *

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Last updated: Tuesday, July 20, 2021 3:49 PM