personal licence disclosure form

If you are the holder of a justices’ licence and you are applying for a personal licence under regulation 8 of the Licensing Act (Personal licences) Regulations 2005 see paragraphs 23 and 28 in Part 3 of Schedule 8 to the Licensing oM�Nvl�h4Q+�&"⽰T��|T\y��ԙ��i��e�%4�-D/!%��5ysb�v[�6�L��5\#�I�!��@+D��p�,�� AwJ$\HoPs��ؐ;�`�؛�'x�H�=:�}�F�� zrؒ; ��j�^��K~ �3��)O��a�AwJ �D�?��5�H�\/Z��ݡU� ��DB�~P�g�%��p�? Disclosure of convictions and declaration form for personal licence. 2. Complete application form Complete disclosure form relating to convictions of relevant offences, immigration offence or penalties Submit original accredited personal licence qualification (this will be returned) Provide two Submit a Home. ��8�A�1~6�s��V6�@)��w��6�`ˮ��*�`"��@:�N}Ilr�\פ�� instructions for video gaming personal disclosure form . Application for a personal licence. You don't need a personal licence to be employed in a pub or business that sells alcohol. You will also need to provide a basic criminal conviction disclosure form . If you cannot complete an application online or by email, you can ask Disclosure Scotland for a paper application form. If you are completing this form by hand please write legibly in block capitals. Applications and licensing contacts. 0 Abridged Personal History Disclosure Form [PDF, 568KB] Personal History Disclosure Form [PDF, 1.5MB] Personal Release Authorisation [PDF, 17KB] Request Form for Review of Decision on an Application for a Special Employee Licence [PDF, 40KB] You can apply directly to Disclosure Scotland without the need for a Registered Body (like DDC) to countersign the application. Personal licence application form - use this form with the disclosure form (PDF, 6 pages, 136kb) Disclosure of convictions (Word, 3 pages, 33 kb) Disclosure of convictions (PDF, 3 pages, 105kb) Application guidance for personal licences (PDF, 7 pages, 214kb) = f?��3-��޲]�Tꓸ2�j)�,l0/%��b� From 6 April 2017 Licensing Authorities are required to check the immigration status and right to work of ALL those applying for Personal Licence. The Council will send you your certificates back. 349 0 obj <>stream If you sell or supply alcohol or supervise the selling or supplying of alcohol you will require a Personal Licence. Credit – Urine Drug Test HQ How to get a personal licence If you are interested in applying for a Personal Licence, you will need to pass a . Please PRINT clearly in INK. Anyone who does not hold a Personal Licence must be authorised to sell alcohol by a Personal Licence holder. If you are completing this form by hand please write legibly in block capitals. If you are completing this form by hand please write legibly in block capitals. 7 April 2017 Form Accredited qualification providers: personal licence to sell alcohol Email response@disclosurescotland.gov.scot to get a paper form. In all cases ensure that your answers Personal Disclosure Form 3: Other Occupational License Forms. Application for a personal licence - please complete the form in full and ensure all the items on the checklist are present Proof that you have a right to work in the United Kingdom - This can be your passport, driving licence or share code so that we can carry out a check on your right to work using the Home Office online checking service You can contact us to get a copy of either form. If you are completing this form by hand please write legibly in block capitals. Personal licence - alcohol and entertainment Disclosure of convictions form File type: DOCX Size: 28.6 KB Disclosure of convictions and civil immigration penalties and declaration Before completing this form please read the guidance notes at the end of the form. How to apply. ��ad� � [Content_Types].xml �(� ĖMK�@��!�U��D��?�Z��]�/v�j�� )�ॐ��>��LGW��d��`��e�W��4�\�,�pJ�`+H�j||4��]*�1\r��H�� If you live overseas, you will need to provide a police record from your country of residence. Before completing this form please read the guidance notes at the end of the form. How do I apply? Before completing this form please read the guidance notes at the end of the form. Personal Licence Application Form (Part 2) Disclosure of convictions and civil immigration penalties and declaration Before completing this form please read the guidance notes at the end of the form. During the lifetime of a licence the licence holder has a duty to notify the Licensing Authority of any change in their name or address. Persons of prescribed description are currently the Master Vintners, persons licensed by the Board of Green Cloth and persons licensed by the University of Cambridge. Save the form on your own computer and check with the journal An application for a personal licence must be made to the licensing authority where the person usually lives, which may not be the licensing authority for the area where they work. A person is to be treated as making a false statement if he produces, furnishes, signs or otherwise The organisation you're going to be working with will tell you what form of ID they will accept. Personal licence for the supply of alcohol for consumption on or off any licensed premises. A guide to the personal and entity disclosure requirements when applying to the AGCO for various licences, authorizations and registrations. A person is to be treated as … Premises licensed to sell alcohol must have a Designated Premises Supervisor (DPS), who holds a personal licence. Review licensing, relicensing, and renewal fees on our fees page . The information contained in this form is correct to the best of my knowledge and belief. If you are currently licensed, and your real estate licence will expire on or after March 31, 2021, please choose the form for “renewals due on or after March 31, 2021”. The original Personal History Details form must be accompanied with a photograph of The information contained in this form is correct to the best of my knowledge and belief. Each person completing this Personal History Details form must submit with it an income tax clearance certificate or equivalent from his/her country of origin. The completed and signed Personal Licence application form; The completed and signed Disclosure of Convictions and Declaration form; Two photographs, one of which must be endorsed on the reverse; and; The cheque for the fee. endstream endobj 304 0 obj <>>>/Filter/Standard/Length 128/O('�k~ޘ�_C�s��7=AF�?�. In all Disclosure of convictions and civil immigration penalties and declaration Before completing this form please read the guidance notes at the end of the form. External link opens in a new �� N _rels/.rels �(� ��j�0@��ѽQ��N/c��[IL��j��]�aG��ӓ�zs�Fu��]��U �� ^�[��x ��1x�p��f��#I)ʃ�Y��*D��i")��c$��qU��~3��1��jH[{�=E��~ Personal licence qualification providers are accredited by the Secretary of State. I work or intend to work in an unlicensed capacity in the business of insurance. They can be contacted on 0870 609 6006. Application for a personal licence PLEASE READ THE FOLLOWING INSTRUCTIONS FIRST Before completing this form please read the guidance notes at the end of the form. If at any time prior to receiving your permanent occupational license there are material changes to the information submitte d herein, you must immediately notify the Commission in writing of the material changes. warning by filing this form, you accept any risk of adverse public notice, embarrassment, criticism, or other action, or financial loss which may result from action taken or not taken with respect to theform and any license application , It is an offence knowingly or recklessly to make a false statement in or in connection with an application for the grant or renewal of a personal licence. To apply for a personal licence you will need to complete the application form and declaration of convictions forms: Click here for the personal licence application Click here for the disclosure … Applicants for personal licences should disclose to the Licensing Authority any previous licences held by them. A guide to the personal and entity disclosure requirements when applying to the AGCO for various licences, authorizations and registrations. If you are completing this form by hand please write legibly in block capitals. If you are completing this form by hand please write legibly in block capitals. Where a Personal Licence is damaged you should enclose the old licence, both the ID card and paper copy. All documents must be the originals, not photocopies. Once you complete this part, you submit the application to Disclosure Scotland. #��td��1�CO�E�&)��t��j�ã��p��o�h��O�2��H� ��W��>y�4 In the event of a change of name or address, the licence holder should serve notice on the licensing authority, the notice to be accompanied by the Personal Licence and the fee of £10.50. Incomplete or improperly completed applications may be returned. and declaration. A full list of accredited personal licence qualification providers can be found on GOV.UK External link opens in a new window You will also need to provide a basic criminal conviction disclosure form . There are three types of DBS checks available. !�ɋ��j�i��2Jv�dw��3 2aI�%B��,��b�db�L`p�6YzS�e�1L`� _��I��{�~r�|�p��4Z>�:+ ĵDt��%\�)BMH8��3��4�p�c� PERSONAL HISTORY DISCLOSURE FORM 3 Casino Employee Registration NJDGE 09/11/2020 Page 1 of 24 Pages Initials: _____ DIVISION OF GAMING ENFORCEMENT • If you are required to obtain a fingerprinted. For Office Use Only F# R# Notes 1. February 13th, 2013 by Jonathan Bazely. �j} C word/document.xml�}�n�H��\%@��!�΀ǉ19!q�Lc�hPR��"5$e�s5�}��}�y�}��)�)Q$%Qv%�m�b��?�X�Ɖ��⯸W ��h�w��Y{��g^��WO0y��w��,��0Lj"L�>.��O��dz^r��q�D��j-��ܟ��(�]ϑ��q4�I��gyთ�ʚ��h��,��øA�zz��)��i�?��Z�ֶ:4�z(��M�7�\c��:5��jI��RM�n- �-��Z�[Һ��N�m��0D7�Q��R�1��^x��g��K��j�S�f�ށ"�Ժ��8;��z�` ��V�_^��m��1�o��ٯ��M��#v�Hϯc��_�%|ѵ5t�>o�aW'A��%�R\�ԓM�r�`��_��-�\��M��hCB��9%ą�w��-Hހ�Հ2�[�t�M��d��֌�7��%!�G̷{o�T�b��.�bo �� f`�{�A�I4{¿��v�� mQTE��W��M�U5��E�d��W�K�.�K6�{� -�!��ɯo�S�hx�� 7bz?v�0M�}/��hb��&��$�@O��)��S�v��zM �q�7?�M��e�O��H ,B/ �:�w=�QbkfG�-ǐ�g��PL:OE}/9A�LQV��a5"� �� H;��O0�- ��!eCo��Bp��gb>F)L��0��hN��O]�`M�69C sQ�4�3,��v3O� Personal Licence Application Form (Part 2) Disclosure of convictions and civil immigration penalties and declaration Before completing this form please read the guidance notes at the end of the form. Page 1 of 3 Disclosure of Convictions and Civil Immigration Penalties and Declaration Before completing this form please read the guidance notes at the end of the form. :?�ņ��F��?+hL� ��z��l}�rt�):��Q��G��^�2��:Ƿx>��Gv��} Ġ?�A��țB�u�|�'�SS}r-��5�I�i��i.�ж��,�Z�0�Ǎ�+� c��=U��NY�~�V�ty�n�V�L6��^J�`�*��.�Q�i�>��m�Xn��d��$hOh=w9��ߤ0��'K7he��W?OL�]�KO�y��6j��:)�yN The aim of the qualification is to ensure that licence holders are aware of licensing law and the wider social responsibilities involved in the sale of alcohol. ��z��ŉ�, � �/�|f\Z��?6�!Y�_�o�]A� �� PK ! Liquor licences require a Basic Disclosure which is issued by Disclosure Scotland (only) for the whole of the UK. Basic Disclosure, Standard DBS Check or Enhanced DBS Check. If you are completing this form by hand please write legibly in block capitals. Application for a personal licence Before completing this form please read the guidance notes at the end of the form. The Licensing Act 2003 places the personal licence holder under a duty to notify the licensing authority of changes in their personal circumstances. Type or print the answers to questions in black ink. The application for the grant of a personal licence consists of: Personal licence application form Disclosure of convictions and declaration Two passport sized photos, one of which must be endorsed as a true likeness (please see Photo Specification below) Licensing qualification certificate. ��$��!�Ľ��4��z�>D��U��ۜ�q�~��W^��iE�j�.��{��Ok׼��؟�?��o��l%I仕ˢRwU��&��^wY��Zй��*'o��LcP'�E�LGQmlHꤚ6B�?��)��=,r�H��Ք��?�SܙoK/��S3}x�e�\�"CWy��p��"��d^� ɶ�Z;T�Z,L��"��{'6 ��[��lS��A�=�v�'��*+|Ӻ�=��6��:X��G_b|��T]>x��=Z� ��g��*��H��x�+��(��i��dWZ�m� A\kb0��~pJ�{L�:��c��:p��~�K�ԟ~o(�]��Z 31:� ϫ�FFŴˎ�9��S��̺�0��_��`L��s�K=�W�-֌e��wb��o:��S/�~��beL�f�P��ȍ��ׯ�߿�Ѐ��Tnz�p2>��z1n\Px��-:J�B��4�E:�A��~��;�_��'L�~��LKut��N)'a��@��Sr6�Ld�d5Y�lP1�X4��8y��6[5�O��U��T-S�L�nTm��/K��ɋԵ|��->N**ۜR�m��e�v�m�#��ҶLמM�2��՟�&?��0�u��hj޼0͙b'�? In the event of a change of name or address, the licence holder should serve notice on the licensing authority, the notice to be accompanied by the Personal Licence and the fee of £10.50. xM7y�hɗO�c��ΟO��$��[��$W�&^� �V&+�pz��i�0yDꇼ�G��L�� kp�)�T��+o6�:C,�� ? By submitting any Personal Information to the Company in any form I acknowledge that such conduct constitutes a reasonable unconditional, specific and voluntary consent to the processing of such Personal Information in the following manner by the Company and/or verification information suppliers: This page has information about how to apply for a personal licence and for current personal licence holders. 303 0 obj <> endobj Personal Licence Guidance Notes . A personal licence is granted to an individual and authorises that person to supply alcohol from establishments with a premises licence. �� PK ! If you are completing this form by hand please write legibly in CRIMINAL HISTORY DISCLOSURE FORM Carefully review this form and the instructions before completing RESPONSES MUST BE TYPED – ATTACH ADDITIONAL TYPED PAGES IF NEEDED Check ONE: I am applying for or renewing a license issued by the Department of Insurance. Form Name Description; SF47367: Occupational License Intake Form: SF47368: Notice and Order of Denial of Occupational License Application: SF47670: Felony Waiver Application: SF51891: Occupational License Separation from Service or Suspension: Read advice notes; Complete application form; Complete disclosure form relating to convictions of relevant offences, immigration offence or penalties; Submit original accredited personal licence qualification (this will be returned) You must answer every question in this application. In all cases ensure that your answers are inside the boxes and written or typed in black ink. Applicants must demonstrate that they have the right to work in the UK and are not subject to a condition preventing them from doing work relating to the carrying on of a licensing activity. and civil immigration penalties. A Basic Disclosure DBS check can be done via the Official UK Government Website. External link opens in a new window If you are applying for a personal licence, you must obtain an accredited qualification first. ... submitting an on-line application and disclosure of convictions. Any personal licence issued in respect of an application made on or after 6 April 2017 will become invalid if the holder ceases to be entitled to work in the UK. Do I need a Disclosure for a Personal Licence (Liquor)? Disclosure of convictions and declaration Before completing this form please read the guidance notes at the end of the form. Obtain a 'Basic Disclosure' conviction disclosure certificate. Form Personal licence: disclosure of convictions and declaration. Page 1 of 6 Application to London Borough of Hammersmith and Fulham for a personal licence Before completing this form please read the guidance notes at the end of the form. Licences and street trading. A Personal Licence lasts indefinitely unless revoked, or forfeited. Personal licence: disclosure of convictions and declaration. Disclosure and Barring Service form (if you live/work in England or Wales) or Disclosure Scotland form (if you live/work in Scotland). Disclosure form for personal licence. If you are the holder of a justices’ licence and you are applying for a personal licence under regulation 8 of the Licensing Act (Personal licences) Regulations 2005 see paragraphs 23 and 28 in Part 3 of Schedule 8 to the Licensing Act 2003 for the information you are required to give. endstream endobj startxref Personal Disclosure Form You may complete this application online and print the document for submission or fill it out by hand. disclosure of personal information, please contact the Freedom of Information Officer at PO Box 9292 STN PROV GVT, Victoria, BC, V8W 9J8 or by phone toll free at 1-866-209-2111. Current personal licence holders Disclosure of convictions and declaration You will be asked on the application form to give details of any convictions you have against you. It is an offence knowingly or recklessly to make a false statement in or in connection with an application for the grant or renewal of a personal licence. Personal Disclosure Form 2 (a) If you are a naturalized citizen, state place of naturalization, including Court granting naturalization: Date of naturalization: (month, day, year) Petition number: Certificate number: (b) If you are an alien, state the “A” number from your Alien Registration Card: (c) If you are an alien authorized to be employed You will find help and advice on qualifications in the Personal Licence Guidance Notes (see below). Business. You must be a personal licence holder to be the designated premises supervisor on a premises licence to authorise the sale of alcohol (unless covered by a temporary event notice). Please PRINT clearly in INK. How to apply for a personal licence To apply for a personal licence you must have: The information contained in this form is correct to the best of my knowledge and belief. PK ! A Personal Licence permits a specified person to sell or authorise the sale of alcohol at a premises that holds a valid Premises Licence. Application for a personal licence PLEASE READ THE FOLLOWING INSTRUCTIONS FIRST. If you are completing this form by hand please write How to surrender your personal licence A holder of For a personal reason If you want a basic disclosure for personal reasons rather than work purposes, apply where you live – Disclosure Scotland (this service) if you live in Scotland, or the Disclosure and Barring Service if you live (Attach a separate sheet to this application if additional space is required.) Disclosure form for personal licence. "��ViD Abridged Personal History Disclosure Form [PDF, 568KB] Personal History Disclosure Form [PDF, 1.5MB] Personal Release Authorisation [PDF, 17KB] Request Form for … Personal History Disclosure Forms Signature: _____ Date: _____ Page 3 of 53 viii. %PDF-1.6 %�� Anyone applying for a Personal Licence will need to undergo a DBS Check as part of their application. Personal licence applications take around 8 weeks to process, providing full information is submitted. "��k�>��C�\��w��\k��\��V*s��L8}�r==�a�%��>��?��_M�͈~nD_�n)��뎎;��늣��sܑ��Z>��;��Yr�!��/V. [Insert name and address of relevant licensing authority and its reference number (optional)] Disclosure of convictions. The holder of a personal licence is also under a duty to notify the licensing authority if he or she is convicted of a relevant offence, foreign offence or immigration penalty. Document downloads. 325 0 obj <>/Encrypt 304 0 R/Filter/FlateDecode/ID[<31574502A0D6BC43810447A0761498B4>]/Index[303 47]/Info 302 0 R/Length 105/Prev 548095/Root 305 0 R/Size 350/Type/XRef/W[1 3 1]>>stream All signatures should be in blue ink. �A,�9mza�&��H�\+��Cc�*��ة��B�ExbX? This takes longer, so try to apply online first. Personal Disclosure Form You may complete this application online and print the document for submission or fill it out by hand. If you are completing this form by hand please write legibly in block capitals. Personal Application Form (WORD) Disclosure of Convictions Application Form (WORD) Two passport size photographs, one of which must be endorsed by a certified person; Original licensing qualification certificate; Basic Disclosure Certificate issued no earlier than one calendar month before the submission of the application to the Licensing Authority; Appropriate fee You must answer every question in this application. h�bbd```b``�"o�H�T��"Ռ��`��`�q0�"Y��lq09�fz"��E&�MN��ٌ `Ә��J��mg``�?�W �8u This is done by contacting a central body called the 'Disclosure and Barring Service': Website: Disclosure and Barring service (GOV.UK website) E-mail: customerservices@dbs.gsi.gov.uk; Telephone: 0300 020 0190 It is an offence knowingly or recklessly to make a false statement in or in connection with an application for the grant or renewal of a personal licence. It is an offence knowingly or recklessly to make a false statement in or in connection with an application for the grant of a personal licence. Personal licence, Grant of - Application form . Gaming Personal Disclosure Form. The information contained in this form is correct to the best of my knowledge and belief. ix. You'll need to show some ID to confirm your identity and address as part of the process. If you are completing this form by hand please write legibly in block capitals. %%EOF A to Z of licences. Application for a personal licence - please complete the form in full and ensure all the items on the checklist are present Proof that you have a right to work in the United Kingdom - This can be your passport, driving licence or share code so that we can carry out a check on your right to work using the Home Office online checking service Use additional sheets if … There is no such requirement for the supply of alcohol in a members’ club. Before completing this form please read the guidance notes at the end of the form. We will then produce new licence documents, and post them to you. When it comes to applying for a DBS Check as part of your Personal Licence application, a Basic Disclosure will do. Disclosure of Interest (Updated February 2021) Please note: Your completed form is NOT to be submitted to the ICMJE and it cannot be saved to the ICMJE website. Complete and sign the Disclosure of Convictions and Declaration Form. Individual (full legal name)
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