Notification of 2 or Less Gaming Machines or
Gaming Machine Permit Application (i.e. for more than 2 machines)
for: New / Variation / Transfer
CALE Alcohol Machine V4 1118 Page 1 of 6
Please refer to guidance notes at the back of this form before completing.
1. Please indicate what you would like to do (please tick the appropriate box):
a) Notify the Licensing Authority that you intend to provide up to a maximum total of
2 gaming machines category C and / or D .........................................................................................................................
(if you choose this option then please complete sections D and E of this form)
b) Apply for a new licensed premises gaming machine permit ........................................................................................
(if you choose this option then please complete sections B, D and E of this form)
c) Apply to vary an existing licensed premises gaming machine permit .......................................................................
(if you choose this option then please complete sections B, D and E of this form)
d) Apply to transfer an existing licensed premises gaming machine permit ...............................................................
(if you choose this option then please complete sections C, D and E of this form)
2. How many gaming machines are you currently authorised to provide and if this is a new or variation
application, how many do you wish to provide? (Please complete the boxes in the table.)
Category of Machine
(See the guidance notes at the rear
of this form regarding the different
categories of machine.)
Number Currently
Authorised to Provide
Number Wish to Provide
(New or Variation)
C
D
C or D
Total
3. If you are currently authorised to provide more than 2 machines, please provide your existing permit, or provide
reasons stating why it cannot be provided.
Existing permit provided* ...........................................................................................................................................................
*Please keep a copy of your existing permit on the premises to which it relates.
Reasons why existing permit cannot be provided (to be completed if appropriate):
(This form is only to be used by
premises licensed to supply alcohol
for consumption on the premises.)
Section A - What do you want to do?
SECTION B
- Application for grant (includes new and variation applications)
4. Name of person requesting the transfer:
5. Confirmation that an application to transfer the relevant Licensing Act 2003 Premises Licence has been:
Requested
Granted
6. Please provide the existing permit, or provide reasons stating why it cannot be provided.
Existing permit provided*
*Please keep a copy of the existing permit on the premises to which it relates.
Reasons why existing permit cannot be provided (to be completed if appropriate)
CALE Alcohol Machine V4 1118 Page 2 of 6
SECTION C - Application for permit transfer (to be used where a transfer has
been requested for the Licensing Act 2003 premises licence)
SECTION D - General Information
7. Name of Premises:
8. Address of Premises
(including postcode):
9. Telephone Number
of Premises:
10. Name of Existing Premises
Licence Holder:
11. Address of Premises
Licence Holder
(if different from 8 above):
12. Telephone Number (daytime)
of Premises Licence holder:
13. E-mail address of Premises
Licence Holder (where available):
14. Name, address, telephone and
e-mail of agent (e.g. solicitor)
if submitted on behalf of the
applicant:
15. Licensing Act 2003 Premises
Licence Reference (i.e. licence
number):
I enclose a sum of (£X)*
(Cheques should be made payable to East Lindsey District Council)
I understand that I must comply with the Gaming Machine Code of Practice for Alcohol Licensed Premise Permits
and Permissions issued by the Gambling Commission. (See Guidance Note 8 overleaf)
Please note: It is an offence under Section 342 of the Gambling Act 2005 if a person, without reasonable excuse,
gives to a Licensing Authority for a purpose connected with that Act information which is false or misleading.
Dated:
Signed (by or on behalf
of Licensing Act 2003
Premises Licence holder):
PRINT Name of Signatory:
*NOTE: FEES PAYABLE
If you wish to have a maximum of 2 gaming machines then the fee payable is £50.00.
If you wish to have more than 2 gaming machines then the fee payable is £150.00.
Transfer of LPGM is £25.00
Variation of LPGM is £100.00
Cheques and postal orders should be made payable to ‘East Lindsey District Council’. Please note that we no longer
accept cash for the payment of licence application fees.
The Licensing Team is able to provide facilities for licence payments by credit and debit cards. Further
information on payment by credit or debit card is available by contacting the Licensing Team direct.
N.B. Your information will be processed in accordance with the law, in particular the Data Protection Act 1998
and the Freedom of Information Act 2000. The information that you provide will only be used for Council
purposes unless there is a legal authority to do otherwise.
To be returned to:
The Licensing Team, East Lindsey District Council,
Tedder Hall, Manby Park, Louth, Lincolnshire LN11 8UP
Telephone: 01507 601111
E-mail: licensing@e-lindsey.gov.uk
Form last revised November 2018
CALE Alcohol Machine V4 1118 Page 3 of 6
SECTION E - Fee and Signature(s)
CALE Alcohol Machine V4 1118 Page 4 of 6
1. This form is to be used for the notification of up
to 2 gaming machines of categories C and / or D
under Section 282 of the Gambling Act 2005, or for
a new application, variation or transfer of an alcohol
licensed premises gaming machine permit under
the Gambling Act 2005.
2. The premises must be licensed under the Licensing
Act 2003 to sell alcohol for consumption on the
premises, without the requirement that alcohol is
served only with food and there must be a bar for
serving alcohol to customers on the premises.
3. The gaming machines must be located on these
licensed premises.
4. A Premises Licence holder is a person holding a
Premises Licence under the Licensing Act 2003.
5. There is no statutory limit to the number of
machines, which may be applied for although the
Licensing Authority has some discretion in this
regard. It is East Lindsey District Council’s policy
that a licensing hearing (consisting of Councillors)
must consider any application for three or more
machines where Licensing Officers are of the
opinion that the premise is not suitable for the
number of machines applied for. It is important
to note that the hearing is unlikely to grant a
permit for more than six machines and even
then six machines will normally only be granted
to exceptionally large premises. It should also be
noted that the Licensing Authority can cancel the
permit or vary the number of machines should
the premises be mainly used for making gaming
machines available for use on the premises
(Schedule 13, Paragraph 16, Gambling Act 2005).
Further information regarding best practice and the
type of premises, which may be suitable for three
or more machines, is available from the Licensing
Team.
6. A permit for 3 or more machines will be subject to
an annual fee. Failure to pay the annual fee may
result in the cancellation of the permit. The annual
fee is £50.00. There are no annual fees payable for
2 machines or less.
7. The Gambling Act 2005 (and associated regulations)
provide for two types of gaming machines, which
can be located in alcohol-licensed premises.
These are:
Category Maximum
stake
Maximum
prize
C £1 £100
D
10p or 30p
non-monetary
£5 cash or £8
non-monetary
With regard to Category D Machines please note
that there are different maximum stakes and prizes
for seaside and amusement arcade type crane
grabs, coin pushers and penny fall machines. Further
information on this type of gaming machine is
available from the Licensing Team.
8. All alcohol licensed premises, which provide gaming
machines for use on the premises must comply
with any relevant Code of Practice issued by the
Gambling Commission under Section 24 of the
Gambling Act 2005. The Gaming Machine Code
of Practice for Alcohol Licensed Premises Permits
and Permissions is available via the Gambling
Commission’s website (www.gamblingcommission.
gov.uk). Should you be unclear as to the provisions
of the code of practice please contact the Gambling
Commission or the Council’s Licensing Team.
9. The Licensing Authority must notify the applicant of
its grant / refusal of the application for a permit as
soon as is reasonable practicable after that decision
to grant / refuse has been made.
10. Where you are notifying the Licensing Authority
of 2 machines or less, you may wish to request an
acknowledgement of receipt of the notification.
The form attached to this application can be
utilised for this purpose.
Guidance Notes
The Licensing Team, Tedder Hall, Manby Park, Louth, Lincolnshire LN11 8UP
Tel: 01507 601111 Email: licensing@e-lindsey.gov.uk
CALE Alcohol Machine V4 1118 Page 5 of 6
Your information will be processed in accordance with the law, in particular the Data Protection Act 1998.
The information you provide will only be used for Council purposes unless we are required by law to do otherwise.
I, (insert name of the Licensing Act 2003 licence holder),
request that this paper is returned to me at the following address and with the details below provided by the
Licensing Authority, so as to acknowledge my notification of two or less gaming machines at: (insert name of
premises)
Insert address (including postcode) to which you wish this acknowledgement to be sent:
Official Use Only (to be completed by the local licensing authority)
Date of receipt of notification of
two or less gaming machines:
Date of receipt of fee:
Signature:
PRINT name of signatory:
Request for acknowledgment of receipt of my
notification of two or less gaming machines
CALE Alcohol Machine V4 1118 Page 6 of 6
Data Protection Notice – Licence, Permit or Registration Application under the
Gambling Act 2005
East Lindsey District Council is a Data Controller and can be contacted at:
Tedder Hall, Manby Park, Louth, Lincolnshire, LN11 8UP
Tel: 01507 601111
The Data Protection Officer for this Authority can be contacted at the same address.
We are collecting your personal data in order to process your licence, permit or registration application under the
Gambling Act 2005 as we are the Licensing Authority.
Your personal data may be shared in the following ways as part of this application:
The Council may also share personal information with the Police and the other Responsible Authorities as part
of the licensing process. Any information sharing will be managed in accordance with relevant privacy and data
protection legislation.
Your data will not be shared with third parties but may be used for Council purposes, in order to prevent or
detect crime, to protect public funds or where we are required or permitted to share data under other legislation.
Some limited Licence, Permit or Registration Holder information will be made available to the public as the
Gaming Act 2005 requires us to maintain a Register of Applications. The Register includes the name of the
Licence, Permit or Registration Holder.
In line with our retention policy your data will be kept for the period of time that you hold an authorisation with
this Authority and then for a further 6 years after your authorisation expires. The data will then be deleted /
destroyed.
We also keep data for six years from the resolution of an unsuccessful application or the resolution of legal
proceedings.
You have the right to access your data and to rectify mistakes, erase, restrict, object or move your data in certain
circumstances. Please contact the Data Protection Officer for further information or go to our website where
your rights are explained in more detail. If you would like to receive an explanation of your rights in paper format
please contact the Data Protection Officer.
Any complaints regarding your data should be addressed to the Data Protection Officer in the first instance. If
the matter is not resolved you can contact the Information Commissioner’s Office at:
Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF
Tel: 0303 123 1113
If you do not provide the information required on the form then we will not be able to process your application.
For further information on our Data Protection Policies please go to our website: www.e-lindsey.gov.uk
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