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APPLICATION FORM[2]
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Licensing (Jersey)
Law 1974
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APPLICATION FORM
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1.
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Full
names of applicant.....................................................................................
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Private
address
.................................................................................................
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Nationality
.......................................................................................................
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Date
and place of birth.....................................................................................
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Place/s
of residence during the 3 years preceding date of application........................................................................................................
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or,
if the application is made by a limited liability Company:
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Name
of Company ..........................................................................................
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Address
of Registered Office
..........................................................................
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When
registered................................................................................................
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Full
name of
Secretary......................................................................................
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or,
if the application is for a licence of the fifth category:
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Name
of Club ....................................................................................................
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When
constituted
..............................................................................................
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Full
name of Secretary .....................................................................................
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Date
and place of
birth......................................................………....................
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2.
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Name
and address of premises in respect of which
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the
application is made......................................................................................
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………………………………………………………………………………...
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Parish................................................................................................................;
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and
name and telephone number of “key holder” or
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other
person with whom access to inspect the
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premises
can be arranged.................................................................................
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...........................................................…………...............................................
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3.
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State
whether or not the premises are registered under the Tourism (Jersey)
Law 1948 ........................................................................................................
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If
so, state –
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In
which register they are registered ........................................................
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Tourism
Registration: No. of persons ......................................................
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Whether
there is a sitting room, other than a barlounge, for the exclusive use of
persons accommodated for reward on the registered
premises....................................................................................................
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In
relation to the 2nd Category only, state whether or not it is desired that
the licence shall be granted subject to the condition that the business
carried out on the premises shall be suspended during the Winter Season
..........................................................................................
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4.
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State whether the Bailiff has granted a permit for public
entertainment on the premises ...........................................................................................................
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Number of persons permitted
...........................................................................
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Whether entertainment is provided, or is to be provided, for
residents or non-residents ............................................................................................................
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In which room/s is the entertainment to be provided
...........................................................................................................................
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5.
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State
the number of open drinking bars on the premises:
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(i)
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Residents
Only Bar/s
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(ii)
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Non
Residents Bar/s
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(iii)
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Other
Bar/s
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I hereby apply for a licence/s of the
................................ category/ies for the sale of intoxicating
liquor on the premises mentioned in paragraph
2, and I declare that the foregoing particulars are correct.
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Date:......................................... Signature:
......................................................
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This form must be signed by the applicant or, in the case of a
limited liability company, or a club, by its Secretary.
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