Application for Licensed Premises
 
This form may take you about 5 minutes to fill in.
You will need the following information/documents to fill in the form:
  • Entity Identifier/UEN of Applicant
  • Details of Licensed Premises
 
Fields marked with asterisk(*) are mandatory
PARTICULAR OF APPLICANT
[This section is to be completed by the chairman/managing director/director/proprietor or a partner of the company/firm. His/her name should appear in the Registry of Companies & Businesses computer printout of information on companies and businesses.]
Applicant's Name*  
Designation*  
Identification Type*  
Applicant NRIC / Passport / FIN number*  
Email Address
 
Contact Number*   (Tel. No) (Fax No)
 
PARTICULAR OF ESTABLISHMENT
Name of Company/Firm *  
Entity Identifier/UEN *  
 
DETAILS OF PROPOSED LICENSED PREMISES
Address of Licensed Premises *  
Type *
Block/House No.
Street Name
Level - Unit No. # -
Building Name
Postal Code *
Licensed Premises Type *  
Type of Goods*   Dutiable Liquor Products
Dutiable Tobacco Products
Dutiable Vehicles & Parts
Dutiable Petroleum Products
Other Dutiable Goods (pls specify)
Strategic Goods
Hazardous Substances
Hazardous Pesticides
Food & Agricultural Products
Telecommunication Equipments
Metals
Plastics
Non Dutiable Vehicles
Non Dutiable Petroleum Products
Other Non Dutiable Goods (pls specify)
 
Responsible person(s) to be contacted(in case of emergency after office hours)
Name*  
Designation*  
Contact Number (At least one to be filled)*   (Tel. No) (Fax No)
Email Address
 
 
Declaration
  1. I/We hereby declare that the information given in this application is true and correct.
  2. I/We also undertake to inform Singapore Customs, immediately of any changes in the particular of this Application Form.