e-form

Cancellation

Licence No.

Title

Name

Surname

Address for correspondence purposes

E-mail

Telephone

Mobile

Nationality

ID Card No.

Nationality

Passport No.

OR

Page 1

Passport No.

Residence Permit Doc. No.

JobsPlus Work Permit No.

Name of Company

Company Registration No.

Name of Business

By means of this application, I, am hereby applying to cancel my Trade Licence.

I confirm that the data supplied in this Form is correct. I hereby give my consent to the Commerce Department to process and record the personal information which I am providing in this Form and to exchange this information with Public Authorities, Government Departments and any other third parties, as necessary, in order to process this Form and as permitted by the Laws of Malta.

I fully understand that:
• by opting out, my Application cannot be processed;

• authorised personnel who are processing this Form may have access to the information provided in this Form for the purpose specified in this Form;

• edited information that would not identify me, may be used for statistical purposes;

• I am entitled to see the information related to me, should I ask for it in writing;

• for the purposes of the Data Protection Act, the Data Controller is the Director General, Commerce Department.

Warning to Applicant

Any false statement, misinterpretation or concealment of material fact on this Form or any other document presented in support of this Application may be grounds for criminal prosecution.

Data Protection Information Note: The Commerce Department collects and processes information provided in this Application to carry out functions under the Trading Licences Act (Cap 441). All data is collected and processed in accordance with the Data Protection Act, Trade Licences Act (Cap 441), other legislation and the Privacy Policy of the Department, a copy of which is available on demand. The information provided in this Form may also be exchanged with other third parties as permitted by Maltese Law.

Helpline: In case of difficulty in completing this Form, contact the Commerce Department on +35621226688 or email on commerce@gov.mt.

Page 2

A Board Resolution signed by the Company Secretary authorising the applicant to represent the Company.