Scrap Metal Dealers Act 2013
Application for a Site Licence
Full name of applicant: / ............
Date of birth: / ......
3.Applicants usual place of residence: / ......
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If applying as a company, name, registered number and address of company: / ......
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If applying as a partnership, full name, date of birth and usual place of residence of each partner: / ......
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Trading name (or proposed trading name): / ......
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Telephone number: / ......
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Email address: / ......
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Address of site to be licensed: / ......
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Full name, date of birth and usual place of residence of site manager if different to applicant: / ......
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Address of any other site (including those outside Wycombe district) where the applicant already carries out or proposes to carry out business of scrap metal dealer: / ......
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Details of any relevant environmental permit or registration held: / ......
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Details of any scrap metal licence issued in the period of 3 years prior to the date of this application: / ......
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Details of the bank account that is proposed to be used for the required cashless transactions: / ......
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Details of any relevant convictions, offences and relevant enforcement action: / ......
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Details of the security arrangements in place to prevent the unlawful purchase, sale or theft of scrap metal: / ......
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Details of the arrangements to record sales, storage and purchase of scrap metal: / ......
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Have you attached a Basic Disclosure Certificate issued for each applicant by Disclosure Scotland: / YES/NO
Is the relevant fee enclosed:
Cheques should be made to Wycombe District Council / YES/NO
Declaration:
The information contained in this form is true and accurate to the best of my knowledge andbelief. I understand that if I make a material statement knowing it to be false, or if I recklesslymake a material statement which is false, I will be committing an offence under Schedule 1 Para5 of the Scrap Metal Dealers Act 2013, for which I may be prosecuted, and if convicted, fined.
I understand that the local authority to whom I make my application may consult other agenciesabout my suitability to be licensed as a scrap metal dealer, as per section 3(7) of the Scrap MetalDealers Act 2013, and that those other agencies may include other local authorities, theEnvironment Agency, the Natural Resources Body for Wales, and the police.
I understand that the purpose of the sharing of this data is to form a full assessment of mysuitability to be licensed as a scrap metal dealer. I also understand that the sharing of informationabout me may extend to sensitive personal data, such as data about any previous criminaloffences. Some details will also be displayed on a national register, as required by the Scrapmetal Dealers Act 2013.
I hereby expressly consent to this processing of my data and display ofrelevant information on the public register.
Signed: Date:
Completed forms and attachments/enclosures should be returned to:
Wycombe District Council, Environment Health, Queen Victoria Road, High Wycombe, Bucks, HP11 1BB