Asset of Community Value Nomination Form

The Assets of Community Value (England) Regulations 2012

If you need assistance in completing this form please email planning@nuneatonandbedworth.gov.uk.


Section 1 Property Details

Name of Property:

Address of Property:



Postcode:

Tel:

Current Occupiers Name:




Section 2 About your Community Organisation

Name of Organisation:

Title: Forename:

Surname:

Position in Organisation:

Email Address:

Address:



Postcode:

Tel:

Organisation type:






How many members do you have (this is particularly important for unincorporated community
groups)?


P.T.O
Please send your completed form to either planning@nuneatonandbedworth.gov.uk or
Head of Development Control, Town Hall, Coton Road, Nuneaton, Warwickshire, CV11 5AA


Parish Council
Neighbourhood Forum
Industrial & Provident
Society
Charity
Unincorporated Community Group
Community Interest Company
Company Limited by Guarantee
Section 3 Supporting Information

Why do you feel the property is an asset to the community? Please give as much information as
possible:































Section 4 Boundary of the Property

What do you consider to be the boundary of the property? Please be as descriptive as possible, and
include a plan if possible.







Section 5 Attachment Checklist







Section 6 Declaration

I can confirm that to the best of my knowledge the information contained in this nomination form is
complete and accurate.

Signed: Date:

Copy of group constitution (if you are a constituted group)
Name & Home addresses of 21 members registered to vote in nomination area (if group is not constituted)
Site boundary plan (if possible)