Section 24(2) |
(To be completed in duplicate). |
APPLICATION FOR REMOVAL OF A LIQUOR LICENCE TO ANOTHER PREMISES. |
(Under the provisions of the Liquor Licensing Act) |
.......................... |
(Date) |
To: The Magistrate, |
Licensing District No ................................ |
I .......................................... of ............................................ holder of a |
(state address) |
licence in respect of premises situate at ............................................ hereby make application for transfer of the said licence to new premises situate at ............................. |
2. | Particulars of new premises |
| (1) | Do these premises occupy an entire building? | .................................... |
| (Answer “Yes” or “No”) |
| (2) | If “No”, what is the rest of the building used for? | .................................... |
| (3) | Do you live “In” or “Near” the premises? | .................................... |
| (Answer “In” or “Near”) |
| (4) | If “Near”, how far? | .................................... |
| (5) | Number of rooms contained in the premises | .................................... |
| (6) | Number of doors | .................................... |
| (7) | Number of windows | .................................... |
3. | (1) | Have you applied for a Certificate before? | .................................... |
| (Answer “Yes” or “No”) |
| (2) | What was the result | |
| (Answer “Granted” or “Refused”) |
| (3) | If “Refused”, state why | .................................... |
| .................................... |
| (Signature of Applicant). |
4. | Number of other licensed premises in your village street or road | .................................... |
Or |
| Number of licensed premises within the radius of a mile? | .................................... |
| Average number of dwellings within the radius of a mile | .................................... |
| Average number of persons residing within the radius of a mile? | .................................... |
Signature of Commissioner of Police. |