REGULATORY SERVICES DEPARTMENT ZOO LICENSING ACT 1981 APPLICATION TO SURRENDER OR CHANGE A ZOO LICENCE. Applicant details. Full Name...
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1 REGULATORY SERVICES DEPARTMENT ZOO LICENSING ACT 1981 APPLICATION TO SURRENDER OR CHANGE A ZOO LICENCE Applicant details Full Name.... (Capitals) Telephone number: Mobile:.... Address if applying as an individual Post Code.. Applicant business (skip if applying as an individual) Commercial register if registered outside of the UK:.. Registration Number if registered in the UK:.. Vat Number if registered:... Legal Status, (Delete as applicable) Private Limited Company / Public Limited Company / Sole Trader Partnership / Public Body / Charity or Association Business name:.. Registered business address: Post Code..
2 Agent details Skip if you are not an agent acting on behalf of the applicant. Full Name.... (Capitals) Telephone number: Mobile:.... Address if you are a private individual acting as an agent: Post Code.. Agent business (skip if you are a private individual acting as an agent) Commercial register if registered outside of the UK:.. Registration Number if registered in the UK:.. Vat Number if registered:... Legal Status, (Delete as applicable) Private Limited Company / Public Limited Company / Sole Trader Partnership / Public Body / Charity or Association Business name:.. Registered business address: Post Code..
3 Zoo license to be surrendered or changed Name of premises / trading name.. Address.. Postcode Existing Licence No:... Expiry Date.. Do you wish this change or surrender to take immediate effect? YES / NO If NO please give us the date planned for the change:... Complete this section if the existing licence holders name has changed Old full name New full name.. Complete this section if there is a new contact name or address Full name of contact.... Address.. Postcode Telephone number: Mobile:... Complete this section to tell us about any other material change You can attach documents, such as drawing or plans, which can help describe your changes.
4 Complete this section if you are surrendering the licence Explain your reasons for surrendering the licence: If moving or getting a new licence please give the local authority issuing the licence. If licence is being replaced by another please give the licence number and issue date. If you are an Insolvency Office Holder or are employed by one you may need to supply the authority with documentary evidence of the events causing the closure and of your authority to act. You can attach copies of relevant documents to this application. Give details of any issues and hazards with closing the premises and your plans to makes the premises safe, including any of the following: There are children or vulnerable adults cared for on the premises There are live animals on the premises There are hazardous materials present on the premises There is hazardous equipment on the premises There are other hazards to health and safety connected with the premises Is there anything else the authority should be aware of?
5 I CERTIFY THAT THE ABOVE PARTICULARS ARE CORRECT AND I AM AWARE OF THE ZOO LICENSING ACT 1981 Signed. Date Capacity Please send completed application to: Operation Directorate Licensing Fourth Floor Bayard Place Broadway Peterborough PE1 1HZ
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