For office use only:
Reference No:
Date Received
Eligible
Letter of confirmation sent:
LOCALISM ACT 2011
NOMINATION FOR INCLUSION ON THE LIST OF ASSETS OF
COMMUNITY VALUE IN NEWCASTLE UPON TYNE
For further information on the Assets of Community Value legislation please see:
http://www.legislation.gov.uk/ukdsi/2012/9780111525791/contents
https://www.gov.uk/government/publications/community-right-to-bid-non-statutory-advicenote-for-local-authorities
Please read the Criteria pack carefully before completing this form.
A
ABOUT YOUR ORGANISATION
1. Name of organisation
2. Contact Details
Main contact for this application – this must be someone who knows about your project
Title
First Name
Surname
Position held in organisation
Address for correspondence:
Postcode:
Is the above your:
Telephone Number
Organisation address
Home address
Mobile Telephone Number
Email address:
Fax Number:
Nomination for inclusion on The list of Assets with Community Value
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3. Evidence of Your Ability to Make a Community Nomination
Type of Organisation
Only certain groups are eligible to make a community nomination. Please tick the box which
best describes your organisation then go to the question indicated in the brackets:
A. Parish Council either for the area within which the nominated land is
situated or the neighbouring area (please now go to question 5)
Voluntary or community bodies
B. A body designated as a Neighbourhood forum pursuant to section 61F of
the Town and Country Planning Act 1990 (please now answer question
4a) then go to question 5)
C. Unincorporated body of at least 21 members which does not distribute its
surplus to members (please now answer questions 4a), 4b) and 4c) then
go to question 5)
D. Charity (please provide your Charity Commission reference number
below) (please now answer question 4a) then go to question 5)
Charity Commission Reference Number:
E. Company limited by guarantee which does not distribute any surplus to
members (please now answer questions 4a) and 4b) then go to question
5)
F. Industrial and Provident Society which does not distribute any surplus it
makes to members (please now answer 4a) then go to question 5)
G. Community Interest Company (please now answer 4a) and 4b) then go to
question 5)
4. Local Connection
If your organisation falls within categories B – G, you will need to provide evidence of your
local connection by answering the questions below and providing further detail where
appropriate.
4.a) Where do your activities wholly or partly occur?
Nomination for inclusion on The list of Assets with Community Value
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4.b) If your organisation falls within category C, E or F, in order to have a local
connection you will need to show that any surplus that your organisation makes is
applied within the Newcastle local authority area or within a neighbouring authority’s
area. Please provide details of where any such surplus is applied:
4. c) If your organisation falls within category C, please provide the names and
addresses of at least 21 members who are registered as a local government elector in
the register of local government electors in either the Newcastle area or a
neighbouring authority’s area?
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B
ABOUT YOUR NOMINATION
5. Asset Information
You must complete the following information about the asset that you are interested in
applying for:
The name and address of the asset;
A description of the nominated land including its proposed boundaries;
All of the information which the nominator has with regard to:
- the names of current occupants of the land,
- the names and current or last-known addresses of all those holding a freehold or
leasehold estate in the land.
Name of Asset:
Address:
Description:
Names and Addresses of current occupants and those holding a freehold or
leasehold estate in the land:
6. You must state below your reasons for thinking that this land is of community
value and that it should be included on the List of Assets with Community Value. You
may wish to consider the checklist for assessing this that is contained on the
website.
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C) SIGNATURE
I confirm that, to the best of my knowledge and belief, all the details in this application are
accurate. I understand that the council may ask for additional information at any stage of
the application process and that you may check this with other sources.
Signed
Date
Name
Please return completed form (by email if possible) to: [email protected]
Alternatively, you can return the completed form to:
Alice Naylor
Property and Asset Management
Room 600
Civic Centre
Newcastle NE1 8PP
This information can be made available in other languages and formats upon
request, such as large print and Braille.
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