| *Contact: | |
| *Company: | |
| Contact Address: | |
| Town / City: | |
| County: | |
| Post Code: | |
| *Contact No.: | |
| Fax: | |
| *Email: |
| Contact Address: | |
| Town / City: | |
| County: | |
| Post Code: | |
| Advertising Contractor: | |
| Commencement of Existing Licence: | |
| Current Display: | |
| Is It Illuminated?: | Yes No |
| Current Income: | |
| When was site first established: | |
| Has the site ever been the subject of actual or threatened planning enforcement?: | Yes
No |
| If yes, please comment: |
| Photograph: | Please Send Seperately |
| Copy of Advertising License: | |
| Site Plan: | |
| Asking Price: |