Application for Certificate to Levy Distress
| Published date | 21 March 2018 |
Application for Certicate to Levy Distress
Please complete this form in BLOCK CAPITALS
In the County Court
Are you applying for (as appropriate)
A rst general certicate to levy distress
A renewal of a general bailiff’s certicate
Part 1
1. Full name
Date of birth
2a. Home
address
Telephone N0.
2b. Business
address
Telephone N0.
as appropriate
2c. Which address is to be used for the purposes of this application? Business Home
2d. Does your area of business extend beyond the district of the court Yes No
at which the application was made?
3a. Have you ever applied for and been refused or had cancelled a Yes No
general or special certicate?
3b. If Yes, please answer the following questions
Court to which the application was made
date the application was refused
or Court at which the certicate was cancelled
date of the cancellation
4. Are you
a. In business alone (i.e. a sole trader) Yes No as appropriate
b. partner in a rm? Yes No
If Yes please give
Full names of all partners
Principal place of business
Part 1 continues overleaf
Rent 3 Application for a Certicate to Levy Distress (05.09)
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