Change of Address Notification for Licence Holders

1. Fair Processing Notice
  
  To find out how we will process and use your personal information in connection with this request please see our Privacy Statement.
Please note only the licence holder can complete this form.
1. Personal Details
2. First name*
3. Surname*
4. Date of birth*
5. Contact phone number*
6. Email*
Label
1. New Address
2. New Address 1*
3. New Address 2
4. New Address 3
5. New Town/City*
6. New Postcode*
1. I advise the Licensing Authority that I have changed my address to the above noted from:
Label
1. Old Address
2. Old Address 1*
3. Old Address 2
4. Old Address 3
5. Old Town/City*
6. Old Postcode*

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