Swansea - Apply for a temporary event notice

Fields marked * are required
I, the proposed premises user, hereby give notice under section 100 of the Licensing Act 2003 of my proposal to carry on a temporary activity at the premises described below.
The personal details of premises user
1. Please read note 1
  
  Your name
2. Title
3. First name(s)*
4. Surname*
5. Add any previous names
6. Previous names (Please enter details of any previous names or maiden names, if applicable.)
7. Title
8. First name(s)*
9. Surname*
11. Date of birth*
12. Your place of birth*
13. National Insurance number example: AB 12 34 56 C
14. Please provide your National Insurance number in the format AB 12 34 56 C*
Your current address
1. We will use this address to correspond with you unless you complete the separate correspondence box below.
2. House name
3. House number
4. Street name*
5. Area
6. City*
7. Postcode*
8. Label
  1. Telephone*
  2. Mobile
  3. Email*
9. Add alternative address for correspondence
Alternative address for correspondence
1. If you complete the details below, we will use this address to correspond with you.
2. House name
3. House number
4. Street name*
5. Area
6. City*
7. Postcode*
8. Alternative contact details
  1. Telephone*
  2. Mobile
  3. Email*
The premises
1. Please give the address of the premises where you intend to carry on the licensable activities or, if it has no address, give a detailed description (including the Ordnance Survey references).
  
  Please read note 2
2. Business name*
3. Building name / number
4. Street name
5. Area
6. City
7. Postcode
8. Detailed description if no address
1. Does a premises licence or club premises certificate have effect in relation to the premises (or any part of the premises)? *
  
  No
  
  Premises licence
  
  Club premises certificate
2. Premises licence number*
3. Club premises certificate number*
4. If you intend to use only part of the premises at this address or intend to restrict the area to which this notice applies, please give a description and details below. Please read note 3.
6. Please describe the nature of the premises below. Please read note 4.
8. Please describe the nature of the event below. Please read note 5.
The licensable activities
1. Please state the licensable activities that you intend to carry on at the premises (please tick all licensable activities you intend to carry on). Please read note 6.
2. *
  
  The sale by retail of alcohol
  
  The supply of alcohol by or on behalf of a club to, or to the order of, a member of the club
  
  The provision of regulated entertainment
  
  The provision of late night refreshment
  
  Are you giving a late temporary event notice
3. Please read note 7 and note 8.
  
  Please state the dates on which you intend to use these premises for licensable activities. Please read note 9.
4. *
5. Please state the times during the event period that you propose to carry on licensable activities (please give times in 24 hour clock). Please read note 10.
6. *
7. Please state the maximum number of people at any one time that you intend to allow to be present at the premises during the times when you intend to carry on licensable activities, including any staff, organisers or performers. Please read note 11.
8. *
9. If the licensable activities will include the supply of alcohol, please state whether the supplies will be for consumption on or off the premises, or both (please tick as appropriate). Please read note 12.
10. On the premises only
  
  Off the premises only
  
  Both
11. Please state if the licensable activities will include the provision of relevant entertainment. If so, please state the times during the event period that you propose to provide relevant entertainment. Please read note 13.
Personal license holders
1. Please read note 14.
2. Do you currently hold a valid personal licence? *
  
  Yes
  
  No
3. If yes, please provide the details of your personal licence below.
4. Issuing licensing authority*
5. Licence number*
6. Date of issue*
7. Date of expiry
8. Any further relevant details*
Previous temporary event notices you have given
1. Please read note 15 and tick the boxes that apply to you.
2. Have you previously given a temporary event notice in respect of any premises for events falling in the same calendar year as the event for which you are now giving this temporary event notice? *
  
  Yes
  
  No
3. If answering yes, please state the number of temporary event notices (including the number of late temporary event notices, if any) you have given for events in that same calendar year*
5. Have you already given a temporary event notice for the same premises in which the event period: a) ends 24 hours or less before; or b) begins 24 hours or less after the event period proposed in this notice? *
  
  Yes
  
  No
Associates and business colleagues
1. Please read note 16 and tick the boxes that apply to you.
2. Has any associate of yours given a temporary event notice for an event in the same calendar year as the event for which you are now giving a temporary event notice? *
  
  Yes
  
  No
3. If answering yes, please state the number of temporary event notices (including the number of late temporary event notices, if any) your associate(s) have given for events in the same calendar year*
5. Has any associate of yours already given a temporary event notice for the same premises in which the event period: a) ends 24 hours or less before; or b) begins 24 hours or less after the event period proposed in this notice?
  
  Yes
  
  No
6. Has any person with whom you are in business carrying on licensable activities given a temporary event notice for an event in the same calendar year as the event for which you are now giving a temporary event notice? *
  
  Yes
  
  No
7. If answering yes, please state the number of temporary event notices (including the number of late temporary event notices, if any) your business colleague(s) have given for events in the same calendar year*
9. Has any associate with whom you are in business carrying on licensable activities already given a temporary event notice for the same premises in which the event period: a) ends 24 hours or less before; or b) begins 24 hours or less after the event period proposed in this notice?
  
  Yes
  
  No
Checklist
1. Please read note 17.
2. I have (please tick the appropriate boxes) *
  
  If the premises are situated in one or more licensing authority areas, sent at least one copy of this notice to each additional licensing authority
  
  If the premises are situated in one or more police areas, sent a copy of this notice to each additional chief officer of police
  
  If the premises are situated in one or more local authority areas, sent a copy of this notice to each additional local authority exercising environmental health functions
  
  Payment will be made using the online payment system on submission of this form
  
  Signed the declaration below
Condition
1. Please read note 18.
  
  It is a condition of this temporary event notice that where the relevant licensable activities described above include the supply of alcohol that all such supplies are made by or under the authority of the premises user.
Declarations
1. Please read note 19.
  
  The information contained in this form is correct to the best of my knowledge and belief.
  
  I understand that it is an offence:
  - i) to knowingly or recklessly make a false statement in or in connection with this temporary event notice and that a person is liable on summary conviction for such an offence to a fine not exceeding level 5 on the standard scale; and
  - ii) to permit an unauthorised licensable activity to be carried on at any place and that a person is liable on summary conviction for any such offence to a fine not exceeding £20,000, or to imprisonment for a term not exceeding six months, or to both.
2. Signature*
3. Date*
Are you a robot?
1. Are you a robot? *
2. Are you sure?
When you click 'submit' you will be taken to our payment system. Please ensure that you fully complete your bank details and progress to the confirmation of payment. If we don't receive your payment we won't be able to process your application.