Renewal Application Form
ADVERTISEMENT
1
2RENEWAL APPLICATION
I. APPLICANT: _________________________________________________________________
(Name of sole owner, partnership, or corporation)
Trade Name: _______________________________________________________________
Permit Number: ________________________
Expiration Date ______________________
Address:
________________________________________________________________
(street)
(city)
(zip code)
(county)
Business Location:
Telephone Nos:
_ inside _ outside city
(h)____________ (b) ____________
Home Address: _____________________________________________________________
(street)
(city)
(zip code)
(county)
II.
LICENSE TYPE
FEE AMOUNT
Class I Manufacturer, Distiller & Rectifier ...............
(
) $9,025.00
Class II Manufacturer, Wine Manufacturer .............
(
) 3,625.00
Class III Manufacturer, Native Wine .......................
(
)
45.00
Native Wine Retailers .............................................
(
)
125.00
Package retailer .....................................................
(
) 1,825.00
On-premises retailer ...............................................
(
)
925.00
On-premises retailer, Wine Only ............................
(
)
475.00
On-premises retailer, Club .....................................
(
)
475.00
Caterer’s, for on-premises retailer .........................
(
)
325.00
Caterer’s ................................................................
(
) 1,225.00
Common carrier .....................................................
(
)
120.00
Solicitor’s ...............................................................
(
)
125.00
Research ...............................................................
(
)
125.00
III. LIST YOUR TAXPAYER IDENTIFICATION NUMBERS:
1. Sales tax number: ____________________________________
2. Social Security Number: _______________________________
Note: For partnership, provide each partner's name and social
security number. (Use separate page if more space is needed.)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Note: For corporation or on-premises club, provide each officer's name and
social security number. (Use separate page if more space is needed.)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
IV. HAS THERE BEEN ANY CHANGE IN YOUR PERMIT DURING THE PAST YEAR
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal