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Wednesday, 08 September 2010
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Application For Licensing Of Premises
Name Of Applicant*
Applicant Email*
Applicant Telephone*
Firm Name *
Firm address
Full names of partners
and / or Directors: *
Nature of occupation
to be licensed: *
Owner of premises: *
Plot No: *
L.R. No.: *
Location: *
Road / Street:*
Town: *
District: *
Business postal address:*
Name of person under
whom processing/trading
will be undertaken: *
Qualifications of person
under whom processing/trading
will be undertaken: *
Mode of payment*
Direct Bank Deposit
Cheque
Money Order
DBD/Cheque/MoneyOrder
Number*
Date Paid: *
Date Slip Sent: *
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