SCRAP METAL DEALERS ACT 2013 APPLICATION FOR A SITE LICENCE Is this a renewal or a new application? Required Please select Renewal New Application Licence Number Date of expiry Are you applying as an individual? Or, on behalf of a company? Required Please select As an individual On behalf of a company Section A The Applicant Full name Required Date of Birth Required Home Address Postcode Lookup Email Address Please confirm your email address Telephone Number Mobile phone number Trading name Your role within the business Any previous names Correspondence address (if different from above) Address Postcode Lookup Email Address A Basic Disclosure and Barring Service Certificate will be e-mailed to licensing after completing this form Please select Yes No Have you been convicted of any relevant convictions? Click this link to see a list of relevant convictions: Have you been convicted of any relevant convictions*? Please select Yes No Date of Conviction Court Offence Sentence Have you been the subject of any relevant enforcement action? Please select Yes No Date of relevant enforcement action Details Details of Relevant Environmental Permit, Exemption or Registration: Do you have planning permission? (applicable only to sites established after 1 November 1990) Please select Yes No Details of any scrap metal licence issued within the last 3 years: License Number Date of application Issuing By(Local Authority) Have you ever been refused a scrap metal licence? Please select Yes No If so please provide details (date and reason): Date of refusal Provide details of refusal There is limit of 255 characters on this field Have you ever had a scrap metal licence revoked? Please select.. Yes No Have you ever been refused a relevant environmental permit Please select Yes No Please state the reason Are you a registered waste carrier? Please select Yes No Waste carrier license number Full name of company Required Registered No: Required Address of registered company Required Postcode Lookup Email Address Required Telephone Mobile Required Directors' details Director/Partner Full Name Date of Birth Home Address Director Email Address Director Telephone Actions Click 'Add another Director' to start completing this question Add another Director A Basic Disclosure and Barring Service Certificate will be e-mailed to licensing after completing this form Required Please select Yes No Company secretary Full Name Secretary Date of Birth Secretary Home address Postcode Lookup Secretary Email Address Secretary Telephone number Secretary Mobile Number A Basic Disclosure and Barring Service Certificate will be e-mailed to licensing after completing this form. Please select.. Yes No Shadow Director Full name Shadow Director Date of Birth Shadow Director Home Address Postcode Lookup Shadow Director Email Shadow Director telephone number Shadow Director Mobile Number Shadow Director A Basic Disclosure and Barring Service Certificate will be e-mailed to licensing after completing this form Please select.. Yes No