Form 5
Regulation 10(2)
ELECTRONICL SIGNATURES REGULATIONS 2012
APPLICATION FOR CONSENT TO TRANSFER LICENCE
The Controller
Name ……………………………………………….of ……………………… (address)
holder of licence No………………….dated…………………………………..
apply for consent to transfer the licence to …………………………………………of
…………………………..(address of proposed transferee)

Dated this ………………..day of…………………20…………..

…………………………..
Applicant

Select target paragraph3