Marriage Act Application Form

Please read the following enclosed documents when completing your application;

a) Guidance for Applicants

The completed form accompanied by the following should be sent to The Register Office;

a) Fee £1600

b) 1 copy of plans of premises; identifying layout of the premises for which you are seeking approval and identifying the ceremony room and the room to be used by the Registrar prior to the ceremony

c) Planning consent – confirming the premises has appropriate planning consent for public use, including marriages and civil partnerships

d) A list of names and addresses of all directors of the company - Where application is made by a

company

The following documents must be made availableat the request of the relevant responsible authority;

Building Control

Fire Safety documentation
Emergency Lighting documentation
Staff training records

Type of Application (Grant or Renewal):
Approval expiry date: / Approval No.
FULL DETAILS OF APPLICANT
1. If applying as individual
Full Name:
Date of Birth:
Home Address:
Telephone No. / Mobile Telephone No.
E-mail address:
Are you the (sole) occupier of the premises:
(if no please provide additional details)
2. If applying as a limited company
Name of Company:
Address of Company:
(please give the address of the registered office and where different state the main trading address of the company):
Is the company the (sole) occupier of the premises:
(if no please provide additional details)
Address for correspondence:
(Acting Agent or if different from applicants)
Name, telephone number and email of contact:
(for inspection purposes)
PREMISES TO BE APPROVED
Name of premises / trading name:
Address of premises:
Telephone No.
RESPONSIBLE PERSON
Full Name:
Occupation:
Telephone No. / Mobile Telephone No.
e-mail address:
DEPUTY TO RESPONSIBLE PERSON(please add up to two extra on an additional sheet)
Full Name:
Occupation:
Telephone No. / Mobile Telephone No.
e-mail address:
PREMISES TO BE APPROVED DETAILS
Description/nature of premises to be licensed:
Are the premises fully accessible to wheelchair users?
Description of Room to be used by Registrar prior to the ceremony:
Number of Ceremony Rooms to be approved:
Name of Room (location)
Dimensions in meters / Maximum No. of people / Description of Room
Name of Room (location)
Dimensions in meters / Maximum No. of people / Description of Room
Name of Room (location)
Dimensions in meters / Maximum No. of people / Description of Room
Name of Room (location)
Dimensions in meters / Maximum No. of people / Description of Room
Name of Room (location)
Dimensions in meters / Maximum No. of people / Description of Room
Name of Room (location)
Dimensions in meters / Maximum No. of people / Description of Room
ANY ADDITIONAL ROOMS SHOULD BE ADDED IN THE BOX BELOW AND INCLUDE THE INFORMATION ASKED FOR ABOVE
DECLARATION BY APPLICANT
1. I have made the above application for the afore mentioned premises to be approved for the
solemnisation of marriages and the registration of civil partnerships.
2. I understand that;
a) the premises will be inspected for suitability before approval is granted and, if this
application is successful, may be subject to subsequent inspection;
b) public notice of the application will appear on the authority’s website for a period of 21
days andthat the authority may also decide to publish it in other ways if it considers it
necessary to do so.
c) approval, if granted, will be for a period of three years, and
d) the authority will need to be satisfied that appropriate health and safety provision and fire
safety is in place.
e) I have consulted with the planning authority as to whether planning consent is required.
3. I confirm that I have read and understand the information contained in this application, the
guidance for applicants and the standard conditions.
4. I declare that:
a) the building has no recent or continuing religious connection
b) if approved I will comply with the standard conditions and local conditions attached to the
approval.
c) the premises are not a register office
5. I confirm that I have enclosed the necessary documentation to proceed with the approval;
a) Fee of £1600.
b) 1 copies of plans of premises; identifying layout of the premises for which you are seeking approval and identifying the room to be used by the Registrar prior to the ceremony
c) Planning consent – confirming the premises may be used for marriages and civil partnerships
Signed: ______
Interest in the Premises: ______
Date: ______
Signature of Responsible Person: ______
Signature of Deputy to Responsible Person: ______
HEALTH & SAFETY ASSURANCE
Health and Safety Laws apply to all businesses. Under the provisions of the Health and Safety at Work etc. Act 1974, as an employer or self-employed person you are responsible for health and safety in your business. Health and Safety Laws are there to protect you, your employees and the public from workplace dangers.
As part of the application assessment process, please provide details of the following documents which you must have in place, as part of your safety management system.
Document/safety management system / Date of issue / Safety Issues identified
Yes/No / Remedial actions and/or annual review completed ( date)
Asbestos report and management plan?
Electrical Safety Certificate
Legionella Risk Assessment and management plan?
Gas Safety Certificate
Lift Safety Report (if applicable)
Public Liability Insurance
Declaration
I ______(name of applicant)
confirm that the above named documents have been issued and any remedial actions identified have been completed in respect of
______(name of venue)
and are a true reflection of the venue at the date of this application.
Signed:______
Dated: ______