Personal licence: disclosure of convictions and declaration

Use this form to declare relevant foreign offences, and forfeiture of a personal licence in the past 5 years, before you apply for a personal licence to sell alcohol.


Disclosure of convictions and declaration

This file may not be suitable for users of assistive technology. Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email Please tell us what format you need. It will help us if you say what assistive technology you use.


To apply for a personal licence to sell alcohol, you need to declare any relevant criminal convictions using the form above, and these may impact on whether you’re found to be suitable as a licensee.

Before completing this application, please read the guidance notes at the end of the form and ensure you have signed both declarations.

Published 19 April 2012
Last updated 7 April 2017 + show all updates
  1. There is a mistake on section 3 of the form. We have published an error notice while the form is being updated.
  2. Updated form published.
  3. First published.