ORKNEY ISLANDS COUNCIL

CIVIC GOVERNMENT (SCOTLAND) ACT 1982

APPLICATION FOR GRANT / RENEWAL OF SEX SHOP LICENCE

Please read the attached guidance notes before completing this form

Please answer Question 1 or 2, and all other questions, continuing on a separate sheet if necessary.

1. To be completed if a natural person

(a) Full name (Block Letters)

(b) Home Address

(c) Telephone No. (If any)

(c) Age, Date and Place of Birth

(d) Is applicant to carry out day-to-day management of the activity?

YES/NO

If not, give full name, address and date and place of birth of any employee or agent so engaged as manager.

2. To be completed if not a natural person

(eg company or partnership)

(a) Full Name

(b) Address of Principal or Registered Office

(c) Full Names, private addresses and dates and places of birth of directors, partners or other persons responsible for its management

(d) Full name, address and date and place of birth of employee or agent to carry on day-to-day management of the activity

IMAGE: The first page is a blank Orkney Islands Council application form for the grant or renewal of a sex shop licence under the Civic Government (Scotland) Act 1982. It contains official-use fields and blank response areas for Questions 1 and 2, covering applicants who are natural persons, companies or partnerships.

3. Premises

(a) Name (if any) and address of premises for which a licence is required hereinafter called “the premises”).

(b) Brief description of premises.

(c) Are premises moveable?

YES/NO

If YES state where it is proposed they are to be used as a sex shop.

4. Opening times

Specify days of the week and the hours during which it is proposed the premises be open to the public.

5. Convictions

Subject to the provisions of the Rehabilitation of Offenders Act 1974, has any party named in this form above ever been convicted of any crime or offence? (continue on a separate sheet if necessary). Please read the guidance notes accompanying this form before completing this section.

6. Previous sex shop licences

(a)

Has any party named in question 1 or 2 above previously held or currently hold a Sex Shop Licence?

YES/NO

If YES, when was the licence granted?

When did/does it expire?

Which Authority granted the licence?

What was its reference number?

(b)

Has any party named in question 1 or 2 above ever applied for and been refused a Sex Shop Licence?

YES/NO

If YES, when were they refused?

Which Authority refused the licence?

IMAGE: The second page continues the blank application form with response areas for premises details, opening hours, convictions, and previous or refused sex shop licences. The convictions section contains a blank table headed “Name”, “Date”, “Court”, “Offence”, and “Sentence”.

DECLARATION

(A) I/We declare that I/We shall, for a period of 21 days commencing with the date hereof, display at or near the premises so that it can conveniently be read by the public, a notice complying with the requirements of Paragraph 2(3) of Schedule 1 of the Civic Government (Scotland) Act 1982.

OR

(B) I/We declare that I/We are unable to display a notice of this application at or near the premises because I/We have no rights of access or other rights enabling me/us to do so, but I/We have taken the following steps to acquire the necessary rights, namely: (specify steps taken) but have been unable to acquire those rights.

Delete (A) or (B) as appropriate. Where declaration (A) is made there must be produced as soon as possible after the 21 days a Certificate that the Applicant has displayed the Notice.

(C) I/We declare that the particulars given by me/us on this form are correct to the best of my/our knowledge and belief.

(D) I/We understand that the information supplied by me/us as detailed in this form may be stored on a computer system by the Authority for the purpose of Licensing and that information may be disclosed to the Police and other relevant parties for vetting and background enquiries whilst processing and determining the application.

(E) I/We understand that the Authority is under a duty to protect the public funds it administers and to this end may use the information I/We have provided on this form for the prevention and detection of fraud. It may also share this information with other bodies responsible for auditing or administering public funds for these purposes.

Signature of Applicant: …………………………………………………… Date: ………………………………

Signature of Agent:
(if applicable) …………………………………………………… Date: ………………………………

Any person who in, or in connection with the making of, this application makes any statement which he/she knows to be false or recklessly makes any statement which is false in a material particular shall be guilty of an offence and liable, on summary conviction, to a fine.

TO BE LODGED WITH LEGAL SERVICES, COUNCIL OFFICES, KIRKWALL, KW15 1NY, TOGETHER WITH THE APPROPRIATE FEE AND DOCUMENTATION

IMAGE: The third page contains the declaration section of the blank application form, including declarations about displaying the application notice, the accuracy of the particulars, the use and disclosure of information, and fraud prevention. It also contains blank signature and date lines, a warning about false statements, and instructions to lodge the form with Legal Services at the Council Offices, Kirkwall, KW15 1NY, with the appropriate fee and documentation.