Application for a minor variation to a premises or club certificate from Newcastle-under-Lyme Borough Council

Step 2 of 4 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.

Email address Confirm email address

Application form

Please attach the completed application form below.

Application form

Supporting documents

All documents are required, unless stated otherwise. Photos of documents are acceptable, as long as all the relevant information is clear. We'll only share these documents with the licensing authority.

Maximum size allowed per file is 10 MB.

We only allow the following file types : doc, docx, gif, jpeg, jpg, pdf, png, ppt, pptx, rtf, txt, xls, xlsx

What if I can't submit all of these documents?

You don't have to submit optional documents, but it may improve your chances of a successful application if you do.

What if I can't submit the documents digitally?

If you can't submit the documents digitally you can send copies by post instead. We'll give you the address and reference number to quote once you've paid the licence fee.

OK, I'll submit all the documents by post instead

Copy of Premises Licence
Copy of current premises licence that is proposed to be varied

Proposed new plan of licensed premises (optional)
IF REQUIRED FOR CHANGE OF LAYOUT - if the application relates to a change of layout please attach the proposed plan

Extra Documentation as required (optional)
If not included in the application please attach any extra documentation relevant to the application

Declaration

I understand it is an offence, liable on summary conviction to a fine not exceeding level 5 on the standard scale, under section 158 of the Licensing Act 2003, to make a false statement in or in connection with this application.
I understand that if I do not comply with the requirements my application will be rejected.
NATIONAL FRAUD INITIATIVE The Council is required under Section 6 of the Audit commission act, 1988 to participate in the National Fraud Initiative dated matching exercise. Information provided to determine Licensing applications will be supplied to the Audit Commission and used for cross system, cross authority and other comparison purposes for the prevention and detection of fraud.

Ticking this box indicates you have read and understood the above declaration

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 the Newcastle-under-Lyme Borough Council privacy notice (opens in new tab).