Fillable 1. Applicant (Guildford Borough Council)

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1. Applicant (Guildford Borough Council)

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Page 1 of 4
APPLICATION FOR PERMISSION TO HOLD A HOUSE TO
HOUSE COLLECTION
HOUSE TO HOUSE COLLECTIONS ACT 1939 S.2
Tick off each of the following before you submit this application form.
You are providing a letter of authorisation from the charity to benefit
You have read the Charitable Collections Policy 2018 and relevant regulations
1. Applicant
Title
Mr ☐
Mrs ☐
Miss ☐
Ms ☐
Full name (s)
Contact address (with postcode)
Telephone number
Mobile number
Email address
2. Charity to Benefit
Name
Address (with postcode)
Charity Registration Number
Purpose of charity
3. Collection Location
The Guildford Borough Council’s area consists of the town of Guildford and the following parishes:
Albury, Artingdon, Ash, Compton, East Clandon, East Horsley, Effingham, Normandy, Ockham,
Pirbright, Puttenham, Ripley, Seale, Send, Shackleford, Shalford, Shere, St Martha, Wanborough,
West Clandon, West Horsley, Wisley and Worplesdon.
Page 2 of 4
4. Collectors
Exact number
5. Dates and Times
Date from:
Date to:
Day
Start time
End time
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
6. Authorisation Given By (you must provide a letter of authorisation from the charity)
Name of individual
Position of individual
7. Items Collected
Is it proposed to collect money?
Yes ☐
No ☐
8. Items Collected 2
Is it proposed to collect other property? If so, of what nature, and is it
proposed to sell such property or to give it away or use it?
Yes ☐
No ☐
If yes, of what nature, and is it proposed to sell such property or to give it away or use it?
9. Remuneration
Is it proposed that remuneration should be paid out of the proceeds of the collection:
(a) to collectors?
(b) (b) to other persons?
If so, at what rates and to what classes of persons?
Page 3 of 4
10. Other Authorities
Are applications being made for licences for collections for the same purpose
in other areas?
Yes ☐
No ☐
If so, what local authorities? And, approximately, how many persons in all is it proposed to authorise to act as
collectors?
11. Previous Applications
Has the applicant, or to the knowledge of the applicant, anyone associated with
the promotion of the collection, been refused a licence or order under the Act
or had a licence or order revoked?
Yes ☐
No ☐
If yes to the above give particulars.
12. Other Applications
Is it proposed to promote this collection in conjunction with a street collection?
Yes ☐
No ☐
If yes, is it desired that the accounts of this collection should be combined wholly or in part with the account of
the street application?
13. Declaration
Signature
Date
click to sign
signature
click to edit
Page 4 of 4
The information you provide on this form will be used by Guildford Borough Council for licensing purposes.
We may share your information and make any other necessary enquiries regarding your application with
other departments and statutory organisations in relation to the application. Your personal information will
be processed in line with Data Protection legislation and we will not disclose information about you to
anyone outside the Council unless the law permits or requires us to.
We will retain your data for as long as it is required for our administrative use, after which it will be
securely disposed of.
If you believe the data we process on you is incorrect you may request to see this information and, if
necessary have it corrected or deleted. If you wish to raise a complaint you can contact our Data
Protection Officer at the address below. If you believe we are not processing your data lawfully you can
complain to the Information Commissioner’s Office (https://ico.org.uk/). Further details are available on our
website - https://www.guildford.gov.uk/dataprotection, or from the Information Rights Officer, Guildford
Borough Council, Millmead House, Millmead, Guildford, GU2 4BB (email: foi@guildford.gov.uk).
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1. Applicant (Guildford Borough Council)

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Completed 26 December 2020

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