Who needs to use this

This form should be used to voluntarily cancel an existing charitable collections licence.

This form is not to be used by organisations moving from one legal structure to another e.g. incorporated association to limited company. A Change of circumstance form is to be used to notify Consumer Protection of a change to a licence holder’s corporate structure.

Instructions 

• Type directly into this form electronically before printing and signing it or hand print neatly using an ink pen in block letters. 
• Tick where appropriate and attach additional pages if space in this form is insufficient. 

Lodging your application

The Charities forms and publications page contains further details on:

• how to lodge this application
• additional Charities forms and
• how to contact us