Surrender of a Personal Licence - Section116 of the Licensing Act 2003

Note

The personal licence will lapse on the day the authority receives the notice of surrender

(* Required field)

Personal Details ( See guidance note 1)
Address ( See Guidance note 2)

  2. hereby surrender my personal licence
Do you have a copy of the original licence?
  1. *
       

Or, the licence is not available because
Address for correspondence

Please confirm all the information on this form is true and accurate
  1. *

Guidance Notes

1 Insert full name of licence holder
2 Insert address of licence holder
3 Give reasons why the licence is not available.

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