Start date	End date	

	
COUNTER-NOTICE
(Given in response to a temporary use notice under Part 9 of the Gambling Act 2005)

This counter-notice is given under section 224 of the Gambling Act 2005 and relates to a temporary use notice given on	in respect of the following premises:
[Identify the premises to which the temporary use notice applies, giving where applicable an address and postcode]

The temporary use notice was given by the following person or organisation:
[Give the name and address of the person or organisation who gave the temporary use notice]

The temporary use notice provided for the premises to be used for the following activities:

during the following period:	
The licensing authority have decided that the temporary use notice referred to in this counter- notice: [tick or check the box or boxes which apply, and give any additional information as appropriate]	

Is not to have effect

Is to have effect only in respect of the following activities:

Is to have effect only during the following period:

Start date	End date	

Is to authorise the activities to take place only at the following times of day:

Date	Start time (hh:mm)	Finish time (hh:mm)	

			

			

Is to have effect subject to the activities being carried out in accordance with the following condition(s) attached in accordance with section 224(3)(d) of the Gambling Act 2005:

This decision has been taken by the licensing authority for the following reasons:

Signed on behalf of the licensing authority:

Signature:

Print Name:

Date: Capacity: