Fillable Schedule 11 SCARBOROUGH BOROUGH COUNCIL Part A Consent (Scarborough Borough Council)

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Schedule 11 SCARBOROUGH BOROUGH COUNCIL Part A Consent (Scarborough Borough Council)

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Schedule 11
Regulation 24
SCARBOROUGH BOROUGH COUNCIL
Licensing Services, Town Hall, St Nicholas Street, Scarborough, YO11 2HG
Part A
Consent of individual to being specified as premises supervisor
I …………………………………………..[full name of prospective premises supervisor]
of………………………………………………………………………………………………..
…………………………………...…[home address of prospective premises supervisor]
hereby confirm that I give my consent to be specified as the designated premises
supervisor in relation to the application for………………………… [type of application]
by…….…………………………………………………………………..[name of applicant]
relating to a premises licence …….…………………[number of existing licence, if any]
for……………………………………………………………………………………………….
……………………….[name and address of premises to which the application relates]
and any premises licence to be granted or varied in respect of this application made
by………………………………………………………………….. ……[name of applicant]
concerning the supply of alcohol at…………………………………………………………
……….………………… [name and address of premises to which application relates].
I also confirm that I am entitled to work in the United Kingdom and am applying
for, intend to apply for or currently hold a personal licence, details of which I set
out below.
Personal licence number ………………………[insert personal licence number, if any]
Personal licence issuing authority…………………………………………………………..
[insert name and address and telephone number of personal licence issuing
authority, if any]
…
…………………… ………….name
…………………………………..dated
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Schedule 11 SCARBOROUGH BOROUGH COUNCIL Part A Consent (Scarborough Borough Council)

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Completed 8 December 2020

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