Templates for alcohol licensing forms

Note: As of 12 July 2021 the forms used for applying to vary, suspend or cancel a licence (s 280) and a managers certificate (s 285) have been updated and approved by the Chief Executive of the Ministry of Justice pursuant to ss 280(2)(a)(external link) and 285(2)(a)(external link) of the Act. Notably:

  • the style has been changed to align with those used in relation to other tribunals and authorities;
  • minor updates have been made to simplify or clarify the language used consistent with the Act; and
  • the forms have been reformatted to enable them to be completed electronically (by way of tick boxes and drop-down menus).

Alcohol licensing form templates

ARLA Application for variation, suspension, or cancellation of licence (for on-licence, off-licence) [DOCX, 62 KB] (previously form 21)

ARLA Application for suspension, or cancellation of managers certificate [DOCX, 54 KB] (previously form 23)

Form 1 - Infringement notice [DOCX, 18 KB]

Form 2 - Infringement offence reminder [DOCX, 18 KB]

Form 3 - On-licence application [DOCX, 20 KB]

Form 4 - Off-licence application [DOCX, 19 KB]

Form 5 - Club licence application [DOCX, 18 KB]

Form 6 - Special licence application [DOCX, 19 KB]

Form 7 - Public notice on off and club licence [DOCX, 14 KB]

Form 8 - Public notice special licence [DOCX, 13 KB]

Form 9 - On-licence (premises that are not a conveyance) [DOCX, 15 KB]

Form 10 - Off-licence [DOCX, 16 KB]

Form 11 - Club licence [DOCX, 14 KB]

Form 12 - Special licence (premises that are not a conveyance) [DOCX, 15 KB]

Form 13 - Special licence (Conveyance) [DOCX, 15 KB]

Form 14 - Application for variation or cancellation of conditions [DOCX, 14 KB]

Form 15 - Notice of renewal of licence [DOCX, 13 KB]

Form 16 - Application for temporary authority [DOCX, 14 KB]

Form 17 - Application for manager's certificate [DOCX, 14 KB]

Form 18 - Manager's certificate [DOCX, 13 KB]

Form 19 - Application for renewal of manager's certificate [DOCX, 14 KB]

Form 20 - Notice of renewal of manager's certificate [DOCX, 13 KB]

Form 22 - Application for variation, suspension, or cancellation of special licence [DOCX, 15 KB]

Form 24 - Search warrant [DOCX, 18 KB]

Form 25 - Request to constitute licensing trust [DOCX, 13 KB]

Form 26 - Notice requesting poll of electors on completion proposal [DOCX, 12 KB]

Form 27 - Notice requesting poll of electors on amalgamation proposal (relating to licensing trusts) [DOCX, 12 KB]

Form 28 - Notice requesting poll of electors on conversion proposal [DOCX, 13 KB]

Form 29 - Notice requesting poll of electors on amalgamation proposal relating to community trusts [DOCX, 13 KB]

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