Fillable 2019.09.20 Amend A Schedule Of Animals Hiring out of horses licence application form - Eastbourne Borough Council

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2019.09.20 Amend A Schedule Of Animals Hiring out of horses licence application form - Eastbourne Borough Council

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The 2019.09.20 Amend A Schedule Of Animals Hiring out of horses licence application form - Eastbourne Borough Council form is 4 pages long and contains:

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Page 1 of 4
The Animal Welfare (Licensing of Activities Involving Animals) Regulations 2018
Amend a schedule of Animals (Horses)
1
Reference number
1.1
Licence Number
1.2
Your reference, if applicable
2
Agent
2.1
Are you an agent acting on behalf of the
applicant?
Yes No If ‘no’, go to 3
Further information about the agent
2.2
Name
2.3
Address
2.4
Email
2.5
Main telephone number
2.6
Other telephone number
3
Licensee Details
3.1
Name
3.2
Address
3.3
Email
3.4
Main telephone number
3.5
Other telephone number
4
Premises Address
4.1
Building name or number
4.2
Street
4.3
Town
4.4
County
4.5
Postcode
4.6
Telephone number
4.7
Email address
5
Horses
5.1
How many horses are kept under the terms
of the Act at the present time?
5.2
How many horses is it intended to keep
under the terms of the Act during the year?
Please provide details of all the horse(s) to be removed from the licence
5.3
Name of horse
5.4
Horse passport number
5.5
Horse Microchip Number
Are there other horses, donkeys, etc to be
removed? If ‘yes’, provide the information
required in 5.3 to 5.5 for all other horses on
an additional sheet (provided on page 4)
Yes/No
Page 2 of 4
Please provide details of all the horse(s) to be added to the licence
5.6
Name of horse
5.7
Horse passport number
5.8
Horse Microchip Number
Are there other horses, donkeys, etc to be
added? If ‘yes’, provide the information
required in 5.6 to 5.8 for all other horses on
an additional sheet (provided on page 4)
Yes/No
6
Vet Inspection Assessment
6.1 Name of veterinary surgeon
6.2 Company name
6.3
Address
6.4 Telephone number
6.5 Email address
6.6
Date of Inspection
Standard payment and declaration section
7
Payment
Payment must be made at the time of making the change
7.1
Confirm date payment of fee made and how
made e.g. online Include reference number
8
Additional information
Please attach the following Information
8.1
Vet Inspection Report
9
Declaration
9.1
This section must be completed by the applicant. If you are an agent, please ensure this section is completed
by the applicant.
9.2
I am aware of the provisions of the relevant Act, Regulations and Statutory Guidance.
The details contained in this form and any attached documentation are correct to the best of my knowledge and
belief.
I understand that a person authorised by the Council may inspect the premises either by appointment or
unannounced at any reasonable time.
I understand that a person authorised by the Council may take photographs or video footage whilst carrying out
inspections or visits to the premises.
I am aware that a fee is payable for this application.
I accept that all veterinary fees incurred by the authority in respect to the licence application will be recoverable
at cost.
I accept that in the event of my application being refused or I withdraw it, I will not be refunded the application
fee or any part thereof under any circumstances.
I accept that on occasion the Council has to provide information to third parties in response to requests made
under the Environmental Information Regulations 2004, Data Protection Act 1998 and Freedom of Information
Acts.
9.3
Signing this box indicates you have read
and understood the above declaration
9.4
Full name
9.5
Capacity
9.6
Date
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
click to sign
signature
click to edit
Page 3 of 4
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 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, Surrey, GU2 4BB
(email: foi@guildford.gov.uk
).
Page 4 of 4
Additional Information
Horses to be Removed
Name of horse
Horse passport number
Horse Microchip Number
Name of horse
Horse passport number
Horse Microchip Number
Horses to be Added
Name of horse
Horse passport number
Horse Microchip Number
Name of horse
Horse passport number
Horse Microchip Number
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2019.09.20 Amend A Schedule Of Animals Hiring out of horses licence application form - Eastbourne Borough Council

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Completed 7 July 2020

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