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Request to be removed as Designated Premises Supervisor

If you wish to cease being the Designated Premises Supervisor at a premise you can request to have your name removed from the Premises Licence by completing the form below. This is covered under the Licensing Act 2003, Section 17, p41. There is no fee payable for this process.

Please note that if you are not the Premise Licence holder you must also complete page 4 of the form and send it to the Premise Licence holder.

If you need more information please contact the Licensing Office using the Contact Details box below.

Contact Us

Licensing Team
Lister Road
Dudley
DY2 8JW

Telephone: 01384 814474 or 01384 815377

Opening hours: 8am to 4pm daily
Applicants are seen by appointment only.