Application For A Licence To Keep A Breeding Establishment For Dogs - Wigan Council Page 2
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1
2
3
4
5
6
7
8A
Applicant's details:
1
Title (
box)
Mr
Mrs
Miss
Ms
Other
2
Surname
3
Forename(s)
4
Home
Address
5
Town
6
Postcode
7
Telephone
Number(s)
8
Date of Birth
D
D
M
M
Y
Y
Y
Y
B
Second applicant's details (if any):
1
Title (
box)
Mr
Mrs
Miss
Ms
Other
2
Surname
3
Forename(s)
4
Home
Address
5
Town
6
Postcode
7
Telephone
Number(s)
8
Date of Birth
D
D
M
M
Y
Y
Y
Y
C
Applicants details if a body corporate (i.e. Limited Company):
1
Name of
Company
2
Registered
Address
3
Town
4
Postcode
5
Telephone
Number
6
Company
Registration No.
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