Consent of premises licence holder to transfer

ALL FIELDS MARKED WITH A * ARE REQUIRED ENTRIES

Please Note:

This form can be submitted online

YOU MUST BE LOGGED IN TO SAVE AND SUBMIT THIS FORM
You are not currently logged in to My Profile, however you may

Complete the form and obtain a printout at the end

If you log in you may

	Pre-populate certain details from your profile account
	Save your form at any time and complete it later
	Submit your form online.

New users click here to , existing users click here to

	Consent of premises licence holder to transfer
	Environmental Health Isle of Wight Council Jubilee Stores The Quay Newport Isle of Wight PO30 2EH
	Please click here to view the fee structure under the Licensing Act 2003. Please Note: An Application for a New Premises Licence or an Application to Transfer a Premises Licence must also be submitted along with this form.

Licence holder details

Title

Other title
(please specify)

Premises details

*	Premises Licence number
*	Name

*	Building name/number
*	Street
*	Town
*	County
*	Postcode
	Telephone Number (include area code)
	Email address

Fields marked '*' are required entries.

Page 1 of 4

Help

P194111