Application to change a licence for a house in multiple occupation from Dacorum Borough Council

Step 2 of 3 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.

Email address Confirm email address

Application form

Please attach the completed application form below.

Application form

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.

What if I can't submit the documents digitally?

If you can't submit the documents digitally you can send copies by post instead. We'll give you the address and reference number to quote once you've completed your application.

OK, I'll submit all the documents by post instead

Property plan(s) (required if you are changing the layout) (optional)
A scale floor plan of the property, showing all rooms and areas which will form part of the HMO.

Basic disclosure certificate for property manager (issued in last 3 months, required if the manager has changed) (optional)
You are required to supply a Basic Disclosure (criminal record) certificate for the individual named in section 6 of the application form, as the Proposed Manager of the Property. This must have been issued no earlier than 3 months prior to the day on which the application is submitted. Please see https://www.gov.uk/request-copy-criminal-record for details on how to obtain this certificate.

Passport picture of applicant (optional)
A scale floor plan of the property, showing all rooms and areas which will form part of the HMO.

Fire safety risk assessment (optional)
This will be passed to the Fire Service for approval and used to help us prioritise inspections

Gas safety certificate (optional)
Recent gas safety certification for any gas appliances within the HMO, completed by a competent accredited person

Portable electrical appliance test certificate (optional)
Recent electrical safety certificate for any portable electrical appliances within the HMO, completed by a competent accredited person

Electrical installation safety certificate (optional)
Recent electrical safety certificate for any electrical installations within the HMO, completed by a competent accredited person

Automatic fire detection system certificate (optional)

Emergency lighting inspection certificate (optional)

Statement of safety of furniture and fittings (optional)

A full copy of the deeds (title absolute) (optional)

Tenancy management agreement (optional)

Energy performance certificate (optional)

Planning consent for building works, conversions, etc (optional)
Where applicable

Building regulation approval for works / conversions (optional)
Where applicable

Building regulation completion certificates for works / conversions (optional)

Declaration

I/we declare that the information contained in this application is correct to the best of my/our knowledge. I/we understand that I/we commit an offence if I/we supply any information to a local housing authority in connection with any of their functions under any of Parts 1 to 4 of the Housing Act 2004 that is false or misleading and which I/we know is false or misleading or am/are reckless as to whether it is false or misleading.
I/we declare that I/we have served a notice of this application on the persons detailed in section 18 of this application, who are the only persons known to me/us that are required to be informed that I/we have made this declaration.
The following additional declarations also apply if (and only if) you have indicated in section 2 of this application that this is a renewal application:
I/We declare that the house in respect of which a licence is sought under Part 2/Part 3 of the Housing Act 2004 is subject to a licence under that part at the time this application is made. I/We further declare that to the best of my/our knowledge either: (a) none of the information described in paragraph 2(c) to (g) of that Act and previously submitted to the authority has materially changed since that licence was granted; OR (b) the only material changes to that information are described in the preceding sections of this application.
Please note: If you are unable to provide all supporting documentation at application stage, we will write to you advising you of what is missing. We will keep your application active for a maximum of three months, to give you time to provide the documents. If, after this period, you fail to provide all outstanding evidence needed to process your application, we will close your application and refund any fees paid by yourself. At this point, if you are operating a licensable HMO without a licence or a valid application for a licence you will be committing an offence and will be open to prosecution. The fine for such an offence could be up to a maximum of £30,000.

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 Dacorum Borough Council privacy notice (opens in new tab).