Name of premises Address line 1 Address line 2 Town County Postcode BC Ref (if known) Description of information requested: Give as much information here as possible in relation to the nature of the request Name Address line 1 Address line 2 Town County Postcode Telephone Email Upload signed confirmation of ownership Please select a file Delete file Upload copy of owners photographic ID e.g. Drivers licence Please select a file Delete file I understand and accept my responsibilities in this regard
