Lisburn Online Forms - Civil Partnership Approval

Title:

First Name:

Last Name:

E-Mail:

Main telephone number:

+

Other telephone number:

+

Street Number and Name:

City or Town:

Post Code:

Country:

Are you applying as a business or organisation?:

YesNo

Is your business registered in the UK with Companies House?:

YesNo

Is your business registered outside the UK ?:

YesNo

Registration Number:

Legal Status:

Legal Status -other:

Your position in the business:

Please describe the nature of the place applied for (e.g. hotel, stately home, civic accommodation) and the primary, and other, uses to which it is regularly put.:

Are you the occupier of the place?:

YesNo

If you answered 'No', and there is another occupier, please give their name(s) and address(es):

Room/Location - Maximum Numbers:

Name:

Occupation:

Private address (including postcode):

Telephone No:

+

Home/Mobile:

+

Name:

Occupation:

Private Address:

Telephone Number:

+

Home/Mobile Number:

+

Do you have public liability insurance?:

Yes
No

Insurance Company:

Policy No::

Period of cover:

Amount of Cover:

A current fire risk assessment:

Yes
No

Date of assessment:

Any relevant licences e.g. under licensing or entertainment legislation?:

Yes
No

Guidance Noes:

I have read and understood the information contained in this form, the 'Guidance Notes' for Applicants for Approval of a Place for Civil Partnerships and Appendix A of the Guidance Notes

place:

The place has no recent or continuing religious connection

permissions:

I have obtained all necessary permissions regarding use of and access to the place

I further declare:

If approval is granted, I will comply with the standard conditions and any local conditions (Appendix A) attached to that grant of approval.

Signature of applicant:

Date (dd/mm/yyyy):

Fees:

Section 1 : Applicant Details
Title:
First Name:
Last Name:
E-Mail:
Main telephone number:	+
Other telephone number:	+
Street Number and Name:
City or Town:
Post Code:
Country:
Your Business
Are you applying as a business or organisation?:	YesNo
If you answer no please go to Section: 2
Is your business registered in the UK with Companies House?:	YesNo
Is your business registered outside the UK ?:	YesNo
Registration Number:
Legal Status:
Legal Status -other:
Your position in the business:
Section 2: Place/location for Civil Partnership
Please describe the nature of the place applied for (e.g. hotel, stately home, civic accommodation) and the primary, and other, uses to which it is regularly put.:
Are you the occupier of the place?:	YesNo
If you answered 'No', and there is another occupier, please give their name(s) and address(es):
Civil Partnership Rooms
Room/Location - Maximum Numbers:
Responsible Persons
Please give details of the person and is/her deputy who will be responsible on the day for arranging and co-ordinating the Civil Partnership Registration and ensuring compilance with requirements and conditions as attached (see Guidance Part 3.1)
Name:
Occupation:
Private address (including postcode):
Telephone No:	+
Home/Mobile:	+
Name:
Occupation:
Private Address:
Telephone Number:	+
Home/Mobile Number:	+
Public Liability
Do you have public liability insurance?:	Yes No
Provide details of the policy
Insurance Company:
Policy No::
Period of cover:
Amount of Cover:
Additional Formalities
Please confirm whether the premises have:
A current fire risk assessment:	Yes No
Date of assessment:
Any relevant licences e.g. under licensing or entertainment legislation?:	Yes No
Section 3: Declaration
Guidance Noes:	I have read and understood the information contained in this form, the 'Guidance Notes' for Applicants for Approval of a Place for Civil Partnerships and Appendix A of the Guidance Notes
place:	The place has no recent or continuing religious connection
permissions:	I have obtained all necessary permissions regarding use of and access to the place
I further declare:	If approval is granted, I will comply with the standard conditions and any local conditions (Appendix A) attached to that grant of approval.
This application may be made by any person. If successful, the applicant will be the holder of the approval.
Signature of applicant:
Date (dd/mm/yyyy):
Fees: