SCHEDULES

Sections 103 and 105.

SCHEDULE 6 S Forms Relating to Registration of Clubs

1 SForm of statement to accompany application by club for grant or renewal of certificate of registration

We, [here state names and qualifications for making statement] [where necessary add and I, owner of the premises to be occupied [oroccupied] by the club hereinafter mentioned] hereby certify that to the best of our knowledge and belief the club designated in the accompanying application is to be [or, in the case of an application by an existing club,has been and is to be] continued as abona fideclub, and not mainly for for the supply of alcoholic liquor.

[Signature, date and address of each person certifying, to be here inserted.]

2 SForm of certificate of registration of clubs to be granted under this Act

Certificate of Registration S

I, , sheriff clerk of, registrar of clubs, hereby certify that club of [here insert registered postal address of all premises used by the club) is registered under the Licensing (Scotland) Act 1976. This certificate shall remain in force until the day of 19 ; application for its renewal must be made not later than the day of, 19 .

Given under my hand this day of, 19 .Registrar of Clubs.