Form 4 Application for new or renewal of off-licence Page 1 of 14
Information sheet –
new or renewal of off-licence
To complete the application you will need to answer all questions, supply all requested documentation and attach the
prescribed fee(s). Please ensure you attach this information sheet when lodging your application.
What to include (please tick)
The original application form plus one copy.
The correct application fee.
The correct annual fee. (new applications only)
Building & Planning certificates for the purpose of s.100 (f) of the Act. (new applications only)
If the applicant is not the owner of the premises or conveyance, written consent from the owner to the effect that the
owner has no objection to a licence being granted. (new applications only)
A copy of all menus, food and drinks. (new applications only)
A copy of the Certificate of Incorporation (new applications only, if applicable).
Good quality scale plans of the premises or conveyance that clearly demonstrate the following: (new applications only)
The design and layout of the premises,
The principle entrance,
Any designated areas - clearly highlighted,
Any proposed permitted area for the display and promotion of alcohol, and any proposed sub-areas.
A photo of the exterior of the premises showing the principal entrance. (new applications only)
Where it must be determined whether the premises are a grocery store, the statement of annual sales revenue
required by regulation 12 or 13 of the Sale and Supply of Alcohol Regulations 2013. (new applications only)
If you are using an alcohol licensing consultant, a letter authorising your consultant to act on your behalf.
When you have all the required documentation, you can lodge your application. Failure to supply all required documents will
result in the application being returned.
Your application must be accompanied by the correct application fee. This is not refundable.
Use the fee calculator overleaf to calculate your risk rating and then tick the appropriate box from the table below. All
applications must be accompanied by the correct application fee. New applications must also be accompanied by the correct
annual fee. Renewal applications do not require an annual fee, this will be invoiced on a date determined by the Napier
District Licensing Committee.
Please ensure you have accurately assessed your fee. Any errors will incur a further application payment and your licence will
not be issued until all outstanding monies are received.
Risk category (risk weighting)
Application/Renewal Fee (inc GST)
If you require assistance calculating your risk rating, please contact the Licensing Inspector on 06 834 4145.