card no.
expiry start security code - last 3 digits issue no. - Switch/
date date
on back
Maestro
Application for Hire Boat Operator
and Vessel Licences
Please return this form and schedule
with your payment to:
Broads Authority Yare House
62-64 Thorpe Road Norwich NR1 1RY
Tel 01603 610734 Fax 01603 756069
Email tolls@broads-authority.gov.uk
Operator’s details
signature ..................................................................................................... date ....................................
cheque/postal order to “the Broads Authority”
cardholders name .................................................................... daytime tel no ..............................................
signature .............................................................................................. date ..............................................
please debit my Mastercard/Visa/Switch/Maestro/Amex
Payment
method
Broads Authority????
This application is being made under Section 94 of the Public Health
Acts Amendment Act 1907 and Section 40 of the Broads Authority Act 2009.
Please read the attached “Hire Boat” and “Hire Boat Operator” conditions and guidance notes
1
before completing this
form. Note that the form need only be completed by operators of hire boats and that the personal details given will only
be used for official purposes. If you are not the Operator, please pass this form on.
name ......................................................................................................... daytime tel no ........................................
address ....................................................................................................................................................................
................................................................................................................................................................................
email ........................................................................................................
Declaration
Vessel details see attached schedule
Hire Boat Operator Licence £ 18.00
TOTAL £ 18.00
•
the particulars given above and on the attached schedule are correct to the best of my knowledge and belief.
•
I have read and understood the conditions and agree to comply with any Authority or statutory conditions.
•
I enclose a copy of the stability and load test report
2
for each boat or class of boat on the attached schedule.
•
the design class boats indicated in the schedule are within the design class definition as detailed in the Hire Boat
Licensing guidance notes.
I apply for the issue of: a Hire Boat Operator’s Licence
and a Hire Boat Licence for boats (enter no. of licences)
Notes
1
The guidance notes provide detailed information on hire boat and operator conditions and amplify them where appropriate.
2
The full stability and load test report/document must be enclosed for each class or individual vessel. For full details of requirements
contact the Broads Authority Operations directorate (address above) or visit www.broads-authority.gov.uk or www.britishmarine.co.uk
3
The licence fee of £5 for each Small Passenger Boat Licence is included in the amount set out on the toll account.
on behalf of ................................................................................................................................................
I declare that:
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