Request to be removed as designated premises supervisor from Portsmouth City Council

Step 2 of 3 Submit the application

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

Please attach the completed application form below.

Application form

I/we understand that a person commits an offence if he fails, without reasonable excuse, to comply with the provisions of the Licensing Act 2003. A person guilty of an offence under this provision is liable on summary conviction to a fine not exceeding level 3 on the standard scale.

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 Portsmouth City Council privacy notice (opens in new tab).