Application For Beer Permit Form - County Of Hamilton, Tennessee printable pdf download

APPLICATION FOR BEER PERMIT

STATE OF TENNESSEE

COUNTY OF HAMILTON

ON-PREMISES PERMIT _______

TAX MAP NO. AND PARCEL

____________________

OFF-PERMISES PERMIT _______

BOARD MEETING DATE: _________________________

ON AND OFF PREMISES PERMIT _______

RECEIPT NO. ________________

DATE RECEIVED ________________

I HEREBY MAKE APPLICATION FOR A PERMIT TO SELL, STORE, MANUFACTURE, OR DISTRIBUTE

BEER OR OTHER BEVERAGES AUTHORIZED TO BE SOLD, STORED, MANUFACTURED OR DISTRIBUTED

UNDER THE PROVISIONS OF TENNESSEE CODE ANNOTATED § 57-5101, et seq., AND BASE MY

APPLICATION UPON THE ANSWERS TO THE FOLLOWING QUESTIONS

Full name of applicant (owner of business) _________________________________________

Type of applicant (check one): Person _______ Firm _______ Corporation _______ Joint-stock Company _______

Syndicate _______

Association _______

Give the name and address of all persons, firms, corporations, joint-stock companies, syndicates or associations having who own

5% or more of the business (attach additional sheet, if needed)

If the owner is an individual, answer questions 4, 5 and 6. Otherwise, proceed to question 7.

What is your present home address? ____________________________________________________________________________

Previous address (es) within the last five (5) years (use additional sheet if necessary)

Date of birth _____________________________ Home Telephone ________________________

Social Security Number _________________________________________

Applicant’s business telephone ______________________________________________________

Under what name will this business operate? _____________________________________________________________________

Give business address and geographical location _________________________________________________________________

________________________________________________________________________________________________________________

10.

Describe the nature of the business you will operate _______________________________________________________________

11.

Name and address of person to receive annual tax notices and any other communication

12.

Name and address of property owner (if other than business owner)

13.

Give the name, date of birth, and address of any manager other than the applicant.

Application For Beer Permit Form - County Of Hamilton, Tennessee