Request to be removed as designated premises supervisor from Chorley Council

Step 2 of 3 Submit the application

Email address

Please provide your email address, so the licensing authority can let you know if your application has been successful or not.

Application form

Please attach the completed application form below.

Declaration

  • Either: I am not the premises licence holder and I understand I am required to give notice of this request to the premises licence holder within 48 hours and I shall comply with this requirement. I understand that if I fail to do so, I commit an offence. Or: I am the premises licence holder and I understand that I must return the premises licence or, if I am unable to do so, I shall give an explanation as to why in this request.
  • I understand that (where I am not the premises licence holder myself) I must give the premises licence holder a notice directing them to return the old premises licence within 14 days and I shall comply with this requirement. I understand that if I fail to do so, I commit an offence.
  • I understand that if I state anything in this application which is false or which I do not believe to be true, I commit an offence.

By continuing, you're giving the Cabinet Office permission to pass the information you're supplying to the relevant authority.

For more details on how your information is used please refer to the Government Digital Service privacy notice (opens in new tab) and Chorley Council.