Change of Proprietor Form
If you are leaving your premises, please complete this form. You may be entitled to a refund.
Required items appear in bold with an asterisk. *
Please enter at least one * of the following so we can contact you.
(Please enter your full telephone/fax number including STD code.)
If you are an existing PRS for Music
customer, please enter your customer reference number, and the business it relates to. e.g. 123456/7P, The Red Lion
Customer reference number
Please enter the date you will be leaving (or have left) the premises
Leaving date *(dd/mm/yyyy)
Please enter the date you will be taking over (or have taken over) the premises
Starting date (dd/mm/yyyy)
Please give a brief description of the (intended) music use at your new premises e.g. radio, TV, disco, live performers, etc. *