Notification of Change of Name or Address of Designated Premises Supervisor

SSDC - Privacy Statement on Handling of Personal Information

To: South Somerset District Council, being the Licensing Authority
Of: The Council Offices, Brympton Way, Yeovil, Somerset, BA20 2HT

Full Name(s) *
Address *
The premises licence holder in respect of premises known as (existing name):
Premises Name *
hereby notify you of a change of name and/or address of Designated Premises Supervisor namely (new nme):
New Premises Name: *
New Postal address of premises: *
Telephone number: *
*I will send the appropriate part of the Premises Licence to the address below. *

*Only applicable to a notification by the holder of the Premises Licence as appropriate
The fee for this application is £10.50
Licensing Authority contact details:
Licensing Service
South Somerset District Council
The Council Offices
Brympton Way
BA20 2HT

Telephone: 01935 462462
Note: Where notice is given by the designateed premises supervisor, who is not the premises licence holder, a copy mst be forwarded to the premises licence holder.
A person commits an offence if he fails, without reasonable excuse, to comply with a requirement of section 33 of the Act. A person guilty of an offence under subsection 33(6) of the Act is liable on summary conviction to a fine not exceeding level 2 on the standard scale.