TV Licensing No-Device Declaration Form

TV Licensing No-Device Declaration Form
Declare that you do not possess or use any TV-receiving equipment at your address.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Property Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Property Type
Is there anyone else at this address who owns or uses TV-receiving equipment?
Please confirm that you do not own, possess, or use any equipment capable of receiving live TV broadcasts or online TV services (such as televisions, set-top boxes, computers with TV tuners, etc.) at this address.
If you previously held a TV license, please enter your previous license number (if known):
Please specify the reason you do not possess any TV-receiving equipment (optional):
For what period does this declaration apply?
If temporary, please specify the end date:
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Additional comments or information (optional):
Signature
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