Principal Authority Resume Form - Gangmasters Licensing Authority (Page 3 of 3) in pdf

Principal Authority Resume Form - Gangmasters Licensing Authority Page 3

This document relates to GLA Brief 48

Please check your answer to the question and then read and sign the declaration below.

Declaration and Consent

Data Protection: information you provide will be held by the GLA. The information will be used

together with other information gathered to assist you should be authorised as the Principal

Authority for the specified licence holder. It may be checked with other Government

Departments and authorities with the legal right to access information held by the GLA. It may

also be checked with financial and other organisations involved in crime prevention for the

purpose of preventing and detecting crime (including the Audit Commission and any other body

with relevant audit powers). This includes overseas equivalents of UK government departments

and enforcement bodies. Please write to the GLA if you wish to make a subject access request

in relation to personal data held by the Authority. Information held by the GLA may be released

on request under the Freedom of Information Act 2000.

The following section must be read, signed and dated.



I understand and accept that the information contained in this document may also be shared

and checked with other Government Departments and their agencies.



I declare that the information given in this form and any supporting material is correct to the

best of my knowledge and belief and that I have not deliberately omitted any necessary

material or made an incorrect statement. I understand that my application may be refused if

deliberate omissions or incorrect statements have been made.



I further understand that deliberate omissions or incorrect statements may be liable to

prosecution and/or sanction.



I understand that the GLA may contact me by telephone and ask for details regarding

personal information and any other information provided within this document. I consent to

this subsequent information being used to assess my suitability to act as Principal Authority

and to inform the licence application and GLA decision process.

Signature

Name of Signatory

Position of Signatory

Date (dd / mm / yyyy)

April 2016

Page 3 of 3

Principal Authority Resume Form - Gangmasters Licensing Authority Page 3