Application for a Street Traders Licence

Is this a new application or a renewal

New Application

Renewal

Is this application commercial or for a charity or voluntary organisation?

Commercial

Voluntary or Charity

1.This application can only be applied for by an individual

Full Name

Title

First

Last

Address

Address 2

City/Town

Post Code

Home Telephone

Mobile

E-mail

Date of birth

Place of birth

2. Criminal Convictions

Do you have any criminal convictions?

Yes

Criminal Convictions

Criminal Conviction 1

Name

Date of Conviction

Convicting Court

Details of Offence

Sentence

Criminal Conviction 2

Name

Date of Conviction

Convicting Court

Details of Offence

Sentence

Criminal Conviction 3

Name

Date of Conviction

Convicting Court

Details of Offence

Sentence

3. Other Licences

Do you hold any other licences

Yes

Other Licence Application

Other Licence 1

Name

Type of Licence

Date Granted

Expiry Date

Issuing Authority

Other Licence 2

Name

Type of Licence

Date Granted

Expiry Date

Issuing Authority

Other Licence 3

Name

Type of Licence

Date Granted

Expiry Date

Issuing Authority

Have you had any other licence applications refused?

Yes

Other Licence Refusal

Licence Refusal 1

Name

Type of Licence

Authority Name

Date of Application

Reason for refusal

Licence Refusal 2

Name

Type of Licence

Authority Name

Date of Application

Reason for refusal

Licence Refusal 3

Name

Type of Licence

Authority Name

Date of Application

Reason for refusal

4. Fitness to Work

Fitness to Work

Does any party directly involved in the day to day licensed activity suffer from, or have any disability, allergy or other condition likely to affect their fitness to operate?

Yes

Person 1

Name

Nature of Condition

Person 2

Name

Nature of Condition

Person 3

Name

Nature of Condition

Photographs

Please attach 2 passport sized photographs

Unlimited number of files can be uploaded to this field.
64 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, rtf, pdf, doc, docx.

Declaration and Information

I declare that the particulars given by me on this form are true and I hereby make application to ��Ƶapp Council for the grant of the licence applied for above. I understand that I, or any person who, in connection with the making of this application makes any statement which I/they know to be false or recklessly makes any statement which is false in a material particular shall be guilty of an offence and liable, on summary conviction, to a fine not exceeding £2500.00.

I also confirm that, if granted a licence, I will comply fully with the conditions of that licence and have, previous to lodging this application, made myself familiar with the terms of ��Ƶapp Councils’ standard conditions pertaining to the licence.

Notes:

Any form lodged which has not been fully completed will be considered incompetent and returned to the applicant.
Please note that the Council may consider the application at a public meeting if there is a valid objection/representation made to the granting of a licence. A hearing of the PPSL Committee will be heard to determine whether the licence should be granted. If there is to be a hearing the applicant will be notified and will be invited to attend.

The information you have supplied on this form will be used for the purpose for which you have provided it, and appropriate measures are in place to protect your personal data. A full privacy notice, which provides information about your rights under current data protection legislation and details about what will happen to your personal data can be found here:

Privacy Notice - Civic Government Licenses

��Ƶapp

Services