Designated premises supervisor forms

Application forms for designated premises supervisors of licensed premises.



Consent form to be completed by a personal licence holder to show they agree to be a designated premises supervisor (DPS).

Variation form to request a change to a premises’ DPS.


The application to vary a premises licence to specify an individual as designated premises supervisor under the Licensing Act 2003 asks the licensee to give a copy of the form to the existing premises supervisor. The completed form contains personal information about the proposed new DPS and sharing this information would be in breach of the Data Protection Act 1998. It is sufficient for the licensee to inform the DPS that the application has been made, without the need to share the specific details of the application. A full copy of the application form must still be sent to police.

The form will be amended via regulations as soon as possible to make this clear.

Published 25 April 2012
Last updated 6 April 2017 + show all updates
  1. Updated forms published.
  2. First published.