Application to vary a premises licence to specify an individual as designated premises supervisor from City of Wolverhampton 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.

Application form

Please attach the completed application form below.

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.

Declaration

  • I/we understand it is an offence, liable on conviction to a fine up to 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.
  • THE INFORMATION GIVEN MAY BE HELD IN MANUAL OR COMPUTERISED FORM AND WILL BE SUBJECT TO THE PROVISIONS OF THE DATA PROTECTION ACT 1998 This authority is under a duty to protect the public funds it administers, and to this end may use the information you have provided on this form for the prevention and detection of fraud. It may also share this information with other bodies responsible for auditing or administering public funds for these purposes.

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 City of Wolverhampton Council privacy notice (opens in new tab).