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Premises licence application - representation form

This representation form can be used to submit representations about a current application to the licensing service.

Please see guidance notes on How to comment or complain about licensed premises | Islington Council for further information and advice about making a representation.

Personal details

First name
Last name
Home address
In what capacity are you making this submission?
If other, please specify:
Telephone number
Email address
Premises name
Full postal address of premises
Licence application reference number (if known)