Personal Licence Change of Name

Before you start...
This form is required if a personal licence holder changes their name by way of marriage or deed poll. To submit this form you will be required to provide these documents: A new passport style photograph and a copy of your Marriage or Deed Poll certificate. A fee of £10.50 will be required, however, a payment link will be sent to you via email when the Licensing Officer has checked your application.
Licence Number
New Name

First name

Last name
Previous Name

First name

Last name
Address

Address Line 1

Address Line 2

City

County

Postcode

Country
Email
Phone

Other Correspondance Address (if Any)
This section applies if you are a solicitor or company applying on behalf of the licence holder.
Name

First name

Last name
Address

Address Line 1

Address Line 2

City

County

Postcode

Country
Email
Phone

Declaration I am entitled to work in the UK and am not subject to a condition preventing me from doing work relating to the carrying on of a licensable activity. I understand that my licence will become invalid if I cease to be entitled to live and work in the UK. The information contained in this form is correct to the best of my knowledge and belief. 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. (A person is to be treated as making a false statement if he produces, furnishes, signs or otherwise makes use of a document that contains a false statement). To do so could result in prosecution and a fine of any amount. It is an offence under section 24B of the Immigration Act 1971 to work illegally.
Yes, I declare