The Licensing Team
Environmental Health & Housing
North Devon Council
PO BOX 379, Barnstaple, Devon,
EX32 2GR
Contact Details:
Tel: 01271 388870
Email:licensing@northdevon.gov.uk
Web:www.northdevon.gov.uk/licensing
PERSONAL ALCOHOL LICENCE UPDATE FORM – LOST, STOLEN, DAMAGED
LICENCE/PHOTOGRAPH UPDATE/REMOVAL OF EXPIRY DATE
Privacy Notice – privacy & data protection
North Devon Council, the Data Controller, collects personal information when you contact us
for the licensing services we provide. We will use this information to provide these services,
such as the granting of a licence, permit, registration or receipt of a notice.
We may need to share your information with other departments in North Devon Council or
external/ third parties, where this is necessary to perform our public functions & services as
provided by law.
For more information as a Data Subject regarding privacy & data protection, including how we
manage your personal information, data retention and your rights, please see our Privacy
Notice on the website: www.northdevon.gov.uk/privacy
If you require this document in an alternative format, please contact
us.
PLEASE READ THE FOLLOWING INSTRUCTIONS FIRST
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 should keep a copy of the completed
form for your records.
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APPLICATION FOR PERSONAL ALCOHOL LICENCE HOLDERS
LOST/STOLEN/DAMAGED LICENCE/ PHOTOGRAPH UPDATES/EXPIRY DATE
REMOVAL
Part 1
Your
(as shown on your Personal Licence)
Title: Mr Mrs Miss Ms Dr Other (please specify)
Surname
Forenames
Address (as shown on your Personal Licence)
Post Town Postcode
Your Personal Licence Number
Part 2
Address for correspondence associated with this application
(if different to
the address above)
Post Town Postcode
TELEPHONE NUMBERS Daytime
Evening
Mobile
Fax Number
E-mail address (if you would prefer us to correspond with you by e-mail)
Part 3
Application type
Application for a copy licence where a licence has been lost
Application for a copy licence where a licence has been stolen
Application for a copy licence where a licence has been damaged
Update to photograph following change in appearance etc
Removal of expiry date following abolition of requirement to renew a licence
Part
4
Checklist
Please tick
I have enclosed my NDDC Personal Alcohol Licence (when available)
I have enclosed my NDDC Personal Alcohol Licence Badge (when available)
I have enclosed two photographs meeting the necessary criteria (for photograph
updates only)
I have enclosed payment of the appropriate fee (£10.50)
(make cheques payable to North Devon Council)
Part 5
Declaration
The information contained in this form is correct to the best of my knowledge and belief.
Signature:
Date:
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