Occasional Licence App.doc
OFFICIAL USE ONLY
Record of Application
DATE
TILL NO.
RECEIPT NO.
INITIALS
FEE
This application must be accompanied
by the appropriate fee and lodged with:
Licensing Section
The City Of Edinburgh Council
249 High Street, Edinburgh EH1 1YJ
T: 0131 529 3223 / 4208 F: 0131 529 4207
Office Hours:
Mon, Wed, Thu: 0830 – 1630
Tue: 1000 - 1630
Fri: 0830 – 1500
www.edinburgh.gov.uk/licensing
APPLICATION FOR OCCASIONAL LICENCE
Before completing this form please read the guidance notes at the end of the form.
If you are completing this form by hand please write legibly in block capitals. In all cases ensure
that your answers are inside the boxes and written or typed in black ink. Use additional sheets,
if necessary.
You may wish to keep a copy of the completed form for your records.
1. LICENCE DETAILS (see note 1)
Premises licence number (if applicable)
Personal licence number (if applicable)
Name of voluntary organisation (if applicable)
2. PERSONAL DETAILS
TITLE (delete as appropriate): Mr Mrs Miss Ms Other (please state)
Surname
Forenames
DATE OF BIRTH
Day Month Year
ADDRESS WHERE ORDINARILY RESIDENT TO BE USED FOR CORRESPONDENCE PURPOSES
Post town Post code
TELEPHONE NUMBERS
Daytime
Evening
Occasional Licence App.doc
Mobile
FAX NUMBER
E-MAIL ADDRESS (if you would prefer us to correspond with you by e-mail)
3. THE PREMISES
Description of premises
Description of activities to be carried on in the premises
Full postal address of premises which this application refers to
4. DURATION OF LICENCE
From:
To:
Occasional Licence App.doc
5. Is alcohol to be sold on & off the premises YES/NO* - Provide relevant details as to hours requested
when alcohol will be sold on/off the premises-* delete as appropriate
Times for sale of alcohol for consumption
on premises
Times for sale of alcohol for consumption off premises
Statement of the times at which any activities other than the sale of alcohol will be carried on in the
premises
6. CHILDREN (see note 2)
This section must be completed where alcohol is for sale for consumption on the premises
Are children or young persons permitted entry? YES/NO (if answered yes the remainder of this section
must be completed)
Ages of children or young persons
permitted entry
Times at which children or young persons permitted entry
Parts of premises to which children or young persons permitted entry
7. CHECKLIST
Please tick yes/no
I have made or enclosed payment of the fee for the application
YES/NO
Occasional Licence App.doc
8. Signature and declaration by applicant (see note 3)
DECLARATION
IT IS AN OFFENCE TO MAKE A FALSE STATEMENT IN OR IN CONNECTION WITH THIS APPLICATION
The contents of this Application are true to the best of my knowledge and belief.
SIGNATURE DATE
NOTES
1. Section 56 of the Licensing (Scotland) Act provides that only:–
The holder of a premises licence;
The holder of a personal licence; or
A representative of any voluntary organisation
is eligible to apply for an occasional licence
2. Where alcohol is to be sold for consumption on the premises, the Act requires that a clear
statement be made as to whether children or young persons are to be allowed entry and, if they
are, a statement of the terms on which they are allowed entry
3. Data Protection Act 1998
The information on this form may be held on an electronic register which may be
available to members of the public on request
4. Information on the Licensing (Scotland) Act 2005 is available on the website of the Scottish
Parliament (http://www.opsi.gov.uk/legislation/scotland/acts2005/20050016.htm)
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