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Personal alcohol licence holder change of name or address
Personal alcohol licence holder change of name or address
Type of change
What is your licence number?
Required
What is the date of issue?
Required
What type of change do you wish to report?
Required
Change of name
Change of address
Your name
Title
Required
Forename
Required
Surname
Required
Change of name
Previous name
Required
Please include your title.
New name
Title
Required
Forename
Required
Surname
Required
Please provide evidence of the name change
Required
Drop files here or click to upload.
Choose a file…
E.g. marriage certificate, deed poll, etc...
Your address
Address
Required
Postcode
Lookup
First line of address
Town
Required
Postcode
Required
Change of address
Please provide your previous address
Required
Postcode
Lookup
Please provide your new address
Required
Postcode
Lookup
Please provide the first line of your address
Required
Town
Required
Postcode
Required
Date of birth
Required
Telephone number
Required
Email address
Required
The information contained in this form is correct to the best of my knowledge and belief
Required
I agree
