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Gambling Act 2005 Application Forms

Gambling Act 2005 application forms are available in PDF and Word format.

Premises Licence Application and Notice of Application Forms

1 Application for Premises Licence - standard form (PDF 69Kb / 5 pages)
Application for Premises Licence - standard form (Word 171Kb / 5 pages)
2 Application for Premises Licence - vessel (PDF 73Kb / 6 pages)
Application for Premises Licence - vessel (Word 170Kb / 6 pages)
3 Application for Provisional Statement - standard form (PDF 69Kb / 6 pages)
Application for Provisional Statement - standard form (Word 164Kb / 6 pages)
4 Application for Provisional Statement - vessel (PDF 69Kb / 6 pages)
Application for Provisional Statement - vessel (Word 166Kb / 6 pages)
5 Notice of Application for Premises Licence - notice to be published (PDF 33Kb / 1 page)
Notice of Application for Premises Licence - notice to be published (Word 40Kb / 1 page)
6 Notice of Application for Premises Licence (Form A) - notice to responsible authorities (one applicant only) (PDF 22Kb / 2 pages)
Notice of Application for Premises Licence (Form A) - notice to responsible authorities (one applicant only) (Word 48Kb / 2 pages)
7 Notice of Application for Premises Licence (Form B) - notice to responsible authorities (more than one applicant) (PDF 28Kb / 2 pages)
Notice of Application for Premises Licence (Form B) - notice to responsible authorities (more than one applicant) (Word 62Kb / 2 pages)
8 Notice of Application for Provisional Statement - notice to be published (PDF 25Kb / 1 page)
Notice of Application for Provisional Statement - notice to be published (Word 41Kb / 1 page)
9 Notice of Application for Provisional Statement (Form A) - notice to responsible authorities (one applicant only) (PDF 21Kb / 2 pages)
Notice of Application for Provisional Statement (Form A) - notice to responsible authorities (one applicant only) (Word 47Kb / 2 pages)
10 Notice of Application for Provisional Statement (Form B) - notice to responsible authorities (more than one applicant) (PDF 28Kb / 2 pages)
Notice of Application for Provisional Statement (Form B) - notice to responsible authorities (more than one applicant) (Word 59Kb / 2 pages)
11 Application to vary a Premises Licence (PDF 69Kb / 5 pages)
Application to vary a Premises Licence (Word 166Kb / 5 pages)
12 Application to transfer a Premises Licence (PDF 62Kb / 5 pages)
Application to transfer a Premises Licence (Word 150Kb / 5 pages)
13 Application for the reinstatement of a Premises Licence (PDF 60Kb / 4 pages)
Application for the reinstatement of a Premises Licence (Word 145Kb / 4 pages)
14 Notice of Application to vary a Premises Licence (PDF 30Kb / 1 page)
Notice of Application to vary a Premises Licence (Word 44Kb / 1 page)
15 Notice of Application to vary a Premises Licence (Form A) - notice to responsible authorities (one applicant only) (PDF 32Kb / 2 pages) 
Notice of Application to vary a Premises Licence (Form A) - notice to responsible authorities (one applicant only) (Word 58Kb / 2 pages)
16 Notice of Application to vary a Premises Licence (Form B) - notice to responsible authorities (more than one applicant) (PDF 40Kb / 3 pages)
Notice of Application to vary a Premises Licence (Form B) - notice to responsible authorities (more than one applicant) (Word 70Kb / 3 pages)

Miscellaneous Application/Notification Forms

1 Application for an Unlicensed Family Entertainment Centre Gaming Machine Permit (PDF 43Kb / 3 pages)
Application for an Unlicensed Family Entertainment Centre Gaming Machine Permit (Word 92Kb / 3 pages)
2 Gaming Machines in Alcohol Licensed Premises Application/Notification (PDF 55Kb / 4 pages)
Gaming Machines in Alcohol Licensed Premises Application/Notification (Word 105Kb / 4 pages)
3 Application for Club Gaming/Club Machine Permit (PDF 43Kb / 6 pages)
Application for Club Gaming/Club Machine Permit (Word 117Kb / 6 pages)
4 Temporary Use Notice (PDF 51Kb / 5 pages)
Temporary Use Notice (Word 157Kb / 5 pages)
5 Temporary Use Notice (Vessel) (PDF 54Kb / 6 pages)
Temporary Use Notice (Vessel) (Word 167Kb / 6 pages)
6 Occasional Use Notice (PDF 51Kb / 4 pages)
Occasional Use Notice (Word 179Kb / 4 pages)
7 Application for Small Society Lotteries Registration (PDF 37Kb / 2 pages)
Application for Small Society Lotteries Registration (Word 96Kb / 2 pages)

For further information

  • Contact: Licensing Team, Town Hall, Penrith, CA11 7QF
  • Office Hours:
    Monday to Thursday 8.45am to 5.15pm
    Friday 8.45am to 4.45pm
  • Email: admin.licensing@eden.gov.uk
  • Telephone: 01768 212148 or 01768 212209 or 01768 212273
  • Fax: 01768 890470
Last updated 21 January 2010