License Form For Employee

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Please Print on Company / Business Headed Paper
Date:
To whom it may concern,
Please be advised that under Part 7 of the Control of Housing and Work (Jersey) Law, 2012;
Name of Employee: ………………………………………………………………………………with
Social Security Number * ……………………………………is deemed to be a Licenced member
.
of staff
As a Licenced employee they are;
Permanently Licenced
OR
Limited Licenced
If time limited, please specify period:
……………………………………………………………..
And are permitted to:
Purchase Property
OR
Lease Only
I declare that the particulars on this form are correct, and I am aware that it is an offence to make
a statement which is false in any material particular.
*If you are a new Licenced individual, please note that a Social Security number will be allocated to you on
receipt of this form
Yours faithfully
Signed on behalf of the employer company
……………………………….…………….
Print Name: …………………………………
Position Held: …………………………………….

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