Get D796

Company details D796 to be filled in by the company making the enquiry Company name and address the company Account number LICENCE CHECK LTD DA00001-81-A Reference number MIDLANDS REGIONAL OFFICE Please delete as appropriate THE RENEWAL TRUST CENTRE Are you making an enquiry on behalf of another company 3 HAWKSWORTH STREET NOTTINGHAM Postcode NG3 2EG Yes No If yes company name must be entered below. IMPORTANT Please read the notes over the page before filling in this form Please write clearly in. Your Company Name Ltd. - Manchester - Distribution Driver details Surname SMYTHE First name KEVIN Date of birth Driver number Middle name s JOHN / S M Y T H Current address K J Address on licence if different Line 1 THE RENEWAL TRUST BUSINESS CENTRE Line 1 Line 2 3 HAWKSWORTH STREET Line 2 Line 3 Post town NOTTINGHAM Post town Postcode You must tell DVLA of any changes to your address. Failure to do so could result in a ne of up to 1000 CPC information please see notes over the page Do you require CPC information Driver declaration DQC number EA89547569 Declaration Being the person referred to in section 2 above I authorise the company or companies listed in Section 1 above to ask DVLA for my driver record information as and when they require at a frequency they shall determine. I understand that the company I authorise to ask for my driver record information may use an intermediary company to make the enquiry with DVLA on their behalf* I authorise and direct DVLA to disclose to the company or companies in Section 1 all relevant information relating to my driver record from the computerised register of drivers maintained by DVLA. This includes personal details driving entitlements endorsement details disqualifications convictions photo images and CPC details where appropriate. Medical information is not to be provided* This authority will expire when I cease to drive in connection with the company and in any case three years from the date of my signature. Your Company Name Ltd. - Manchester - Distribution Driver details Surname SMYTHE First name KEVIN Date of birth Driver number Middle name s JOHN / S M Y T H Current address K J Address on licence if different Line 1 THE RENEWAL TRUST BUSINESS CENTRE Line 1 Line 2 3 HAWKSWORTH STREET Line 2 Line 3 Post town NOTTINGHAM Post town Postcode You must tell DVLA of any changes to your address. Failure to do so could result in a ne of up to 1000 CPC information please see notes over the page Do you require CPC information Driver declaration DQC number EA89547569 Declaration Being the person referred to in section 2 above I authorise the company or companies listed in Section 1 above to ask DVLA for my driver record information as and when they require at a frequency they shall determine. Failure to do so could result in a ne of up to 1000 CPC information please see notes over the page Do you require CPC information Driver declaration DQC number EA89547569 Declaration Being the person referred to in section 2 above I authorise the company or companies listed in Section 1 above to ask DVLA for my driver record information as and when they require at a frequency they shall determine. I understand that the company I authorise to ask for my driver record information may use an intermediary company to make the enquiry with DVLA on their behalf* I authorise and direct DVLA to disclose to the company or companies in Section 1 all relevant information relating to my driver record from the computerised register of drivers maintained by DVLA.