Application for a scrap metal licence
Section 1. Licence type (for all applicants)
Please indicate the type of licence you are applying for (please tick):
Site licence Collector’s licence
Are you applying as (please tick):
An individual
A company
A partnership
Please state your trading name:
Is this application for a grant of a new licence or a renewal (please tick the relevant box):
Grant of a new licence Renewal of an existing licence
If ‘yes’ please provide your existing licence number:
Section 2. Permits, registrations and licences in force (for all applicants)
Please provide details of any relevant environmental permit, exemption or registration (such
as a scrap metal dealer or a motor salvage operator) in relation to the applicant:
Type: Identifying number: Date of issue:
Type: Identifying number: Date of issue:
Continue on a separate sheet if necessary.
Please provide details, including licence number, of any other scrap metal licence issued by
any authority to the applicant within the last 3 years (
continue on a separate sheet if
necessary).
Are you registered as a waste carrier? (please tick)
Yes No
If ‘yes’ please provide your carrier’s registration number:
2
Section 3. Site licence (to be completed if applying for a site licence)
A site licence authorises the licensee to carry on business at a site in the
authority’s area. You can apply to licence multiple sites using this form.
Details of prospective licence holder
Contact details: W
e will use your business address to correspond with you unless you
indicate we should use your home address.
Business address:
Head office n
ame or house name or number:
First line of address:
Town or city:
Postcode:
Daytime phone number:
Evening phone number:
Mobile number:
Home address:
House name or number:
First line of address:
Town or city:
Postcode:
Please use my home address for
correspondence
Email address (if you would prefer us to
correspond with you by email):
Please note th
at you must still provide us
with a postal address
3
Site details. Please list the details for each site where you propose to carry on business as
a scrap metal dealer in this local authority area. If you operate more than two sites in the
area please provide details for each site on a continuation sheet. If the applicant operates
multiple sites within a licensing authority area, provision should be made for more than one
site manager.
Full address of each site you intend to carry
out business as a scrap metal dealer:
Site manager
applicant):
Site 1
Name or number:
First line of address:
Town or city:
Postcode:
Telephone number:
Email address:
Website address:
Name:
1
House name or number:
2
First line of address:
Town or city:
Postcode:
Date of birth:
Basic disclosure certificate attached:
Yes
No
3
Site 2
Name or number:
First line of address:
Town or city:
Postcode:
Telephone number:
Email address:
Website address:
Name:
House name or number:
First line of address:
Town or city:
Postcode:
Date of birth:
Basic disclosure certificate attached:
Yes
No
1
Please also state your maiden name or any other surnames you have previously been known by.
2
Please provide the site manager’s home address as this will facilitate conducting checks on whether
they are a suitable person.
3
If you do not provide a disclosure certificate issued for the named person by the Disclosure and Barring Service,
no more than three months before the date of this application, your application may be delayed or rejected.
4
Individuals Please complete this section if you are applying as an individual.
Title (please tick):
Mr Mrs Miss Ms Other
(please state):
I am 18 years old or over. Please tick
Yes No
Date of birth:
Surname:
Forenames:
Please also state your maiden name or any other surnames you have previously been known
by:
Position or role in the business:
I attach a basic disclosure certificate issued for the applicant by the Disclosure and Barring
Service (DBS):
Yes No
If you do not provide a disclosure certificate your application may be delayed or rejected.
Partnerships If you are applying as a partnership, please provide the following details for
each partner. Where there are more than two partners then please continue
on a separate sheet.
Full name:
4
Date of birth:
Residential address:
Basic disclosure certificate attached:
Yes
No
5
Full name:
Date of birth:
Residential address:
Basic disclosure certificate attached:
Yes
No
4
Please also state your maiden name or any other surnames you have previously been known by.
5
If you do not provide a disclosure certificate issued for the named person by the Disclosure and Barring Service,
no more than three months before the date of this application, your application may be delayed or rejected.
5
Companies If you are applying as a company please provide the details s
et out below
about the company.
Company name:
Registration number:
Address of the registered office:
Please provide the following details for each director, shadow director and company
secretary where these are different from the applicant and site manager
(continue on a
separate sheet if necessary).
Role:
Name:
Date of birth:
House name or number:
First line of address:
Town or city:
Postcode:
Basic disclosure certificate attached:
Yes No
6
Role:
Name:
Date of birth:
House name or number:
7
First line of address:
Town or city:
Postcode:
Basic disclosure certificate attached:
Yes
No
8
Please provide details of any site in the area of any other local authority at which the
applicant carriers on business as a scrap metal dealer or proposes to do so:
Address:
Postcode:
Please name the local authority which has licensed this site, or to whom applications have
been made if before commencement of the Scrap Metal Dealers Act 2013:
Please continue on a separate sheet if necessary.
6
If you do not provide a certificate issued for the named persons no more than three months before the date of
this application, your application may be delayed or rejected.
7
Please provide the director’s home address as this will facilitate conducting checks on whether they
are a suitable person.
8
If you do not provide a disclosure certificate issued for the named person by the Disclosure and Barring Service,
no more than three months before the date of this application, your application may be delayed or rejected.
6
Only applicable to sites established after 1 November 1990
Do you have planning permission (please tick)
Yes No
Section 4. Collector’s licence (
To be completed if applying for a collector’s
licence)
A collector’s licence authorises the licensee to carry out business as a
mobile collector in the authority’s area only.
Details of prospective licence holder
Companies or partnerships (if you are applying as a company or partnership please provide
the details set out below about the company or partnership)
Company name:
Trading name (if different):
Registration number:
Individuals (If you are applying as an individual please provide the details set out below)
Title (please tick):
Mr Mrs Miss Ms Other
(please state):
I am 18 years old or over. Please tick
Yes No
Date of birth:
Surname:
Please also state your maiden name or any other surnames you have previously been known
by:
I attach a basic disclosure certificate issued for the applicant by the Disclosure and Barring
Service (DBS):
Yes No
If you do not provide a disclosure certificate your application may be delayed or rejected.
7
Contact details (We will use your business address to correspond
with you unless you
indicate we should use your home address)
Business address:
House name or number:
First line of address:
Town or city:
Postcode:
Daytime phone number:
Evening phone number:
Mobile number:
Home address:
House name or number:
First line of address:
Town or city:
Postcode:
Email address (if you would prefer us to
correspond with you by email):
Please note
that you must still provide us
with a postal address
Please use my home address for correspondence
Where will scrap metal that has been purchased be stored before further disposal?
House name or number:
First line of address:
Town or city:
Postcode:
Will not be stored
Section 5. Motor salvage (for all applicants)
Will your business consist of acting as a motor salvage operator? This is defined as a
business that:
wholly or in part recovers salvageable parts from motor vehicles for re-use or re-sale,
and then sells the rest of the vehicle for scrap;
wholly or mainly involves buying written-off vehicles and then repairing and selling
them off; and,
8
wholly or mainly buys or sells motor vehicles for the purpose of salvaging parts from
them or repairing them and selling them off.
(please tick)
Yes No
To operate as a motor salvage operator you will need to apply for a site licence.
Section 6. Bank accounts that will be used for payments to suppliers (for all
applicants)
Please provide details of the bank accounts that will be used to make payment to suppliers,
in accordance with section 12 of the Scrap Metal Dealers Act 2013. If more than two bank
accounts will be used, please continue on a separate sheet.
Account name:
Sort code:
Account number:
Account name:
Sort code:
Account number:
Section 7. Payment (for all applicants)
How do you wish to make payment for your scrap metal dealer’s licence? (please tick)
Direct Debit (please complete separate Direct Debit form)
Cheque (please make payable to Harlow Council)
Section 8. Criminal convictions (for all applicants)
Have you, any listed partners, any listed directors, or any listed site manager(s) in this
application ever been convicted of a relevant offence or been the subject of any relevant
enforcement action? (Please see below for a list of relevant offences).
Yes No
If ‘yes’ you must provide details for each conviction, the date of the conviction, the name and
location of the convicting court, offence of which you were convicted and the sentence
imposed:
9
Please return your completed form to:
Licensing
Harlow Council
Civic Centre
The Water Gardens
College Square
Harlow CM20 1WG
Tel: 01279 446005
Section 9. Checklist (for all applicants)
I have (please tick appropriate boxes):
enclosed a basic disclosure form dated wit
hin 3 months for
each applicant, director and partner
enclosed two passport photographs (collectors only)
enclosed the application fee
enclosed copies of any environmental permit, exemption or
registration
signed the declaration in section 10
Section 10. Declaration (for all applicants)
The information contained in this form is true and accurate to the best of my knowledge and
belief. I understand that if I make a material statement knowing it to be false, or if I recklessly
make a material statement which is false, I will be committing an offence under Schedule 1
paragraph 5 of the Scrap Metal Deale
rs Act 2013, for which I may be prosecuted, and if
convicted, fined.
I understand that the local authority to whom I make my application may consult other
agencies about my suitability to be licensed as a scrap metal dealer, as per section 3(7) of
the Scrap Metal Dealers Act 2013, and that those other agencies may include other local
authorities, the Environment Agency, the Natural Resources Body for Wales, and the police.
I understand that the purpose of the sharing of this data is to form a full assessment of my
suitability to be licensed as a scrap metal dealer. I also understand that the sharing of
information about me may extend to sensitive personal data, such as data about any
previous criminal offences. Some details will also be displayed on a national register, as
required by the Scrap Metal Dealers Act 2013. I hereby expressly consent to this processing
of my data and display of relevant information on the public register.
Signed: Date:
Signed: Date:
Signed: Date:
Signed: Date:
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