BIRMINGHAM CITY COUNCIL
BIRMINGHAM CITY COUNCIL
LICENSING ACT 2003 – NOTICE TO SURRENDER PREMISES LICENCE
I ……………………………………………………………………………………………
(Licence Holder)
Wish to surrender the Premises Licence granted to me in respect of the following premises:-………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
(Name and Address of Premises)
Premises Licence Number………………………………………………………………
Please find attached the original Premises Licence / I am unable to return the Premises Licence for the following reason (delete as appropriate)
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
I am aware that whilst I wish to surrender the Premises Licence with immediate effect I am still liable to pay any outstanding annual fees which have accrued prior to me surrendering the licence.
Print Name: ………………………………………………..
Signature: ………………………………………………...
Capacity: ……………………………………………………..
(if Company – Director/Company Secretary/Solicitor for the Licence Holder)
Dated: ………………………………………………….
Please return to:
General Licensing Regulation & Enforcement, P.O. Box 17831, Birmingham, B2 2HJ
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