Request a copy of a personal alcohol licence or change licence details

Type of change

Purpose of notification Required

Replacement

Change of address

Change of name

Title Required

Forename Required

Surname Required

Licence Number Required

Date of issue Required

Address Required

Postcode

Email Required

Contact telephone number Required

Title Required

Forename Required

Surname Required

Address Required

Postcode

Daytime phone number

Evening phone numbers

Mobile telephone numbers

If you would prefer us to correspond with you by email

Would you like correspondence associated with this application to be sent to a different address than given above? Required

Address for correspondence

Postcode

Correspondence daytime telephone

Correspondence evening telephone

Correspondence mobile telephone

Correspondence email

Would you like to submit a new photograph? Required