Interim authority notice from Erewash Borough Council

Step 2 of 4 Submit the application

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

Please attach the completed application form below.

Application form

I HAVE NOTIFIED THE DESIGNATED PREMISES SUPERVISOR (IF DIFFERENT FROM THE PREMISES LICENCE HOLDER), IF ANY.
I CONFIRM THAT I AM ENTITLED TO WORK IN THE UNITED KINGDOM.
I UNDERSTAND IT IS AN OFFENCE, UNDER SECTION 158 OF THE LICENSING ACT 2003, TO MAKE A FALSE STATEMENT IN OR IN CONNECTION WITH THIS APPLICATION.

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