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All fields marked with a * are required entries
  Licensing Act 2003

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Application for the review of a premises licence under the Licensing Act 2003
Environmental Health
Isle of Wight Council
Jubilee Stores
The Quay
Newport
Isle of Wight
PO30 2EH
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* I/We     (Insert name of applicant) apply for the review of a premises licence under section 51 of the of the Licensing Act 2003 for the premises described in Part 1.
Part 1 - Premises Details
Premises licence number
(if known) 

Building name/number
Street
Town
County
Postcode
If no postal address please provide ordnance survey map reference
Name of premises licence holder (if known)  

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