Application For A Beer Permit Form printable pdf download

APPLICATION FOR A BEER PERMIT

STATE OF TENNESSEE

CITY OF LOUDON

Application for (check one):

______ ON PREMISES PERMIT

______ OFF PREMISES PERMIT

______ ON AND OFF PREMISES PERMIT

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 SECTION 57-5-101 ET SEQ. AND BASE MY APPLICATION UPON THE

ANSWERS TO FOLLOWING QUESTIONS:

1. Full name of applicant (owner). _________________________________________________

__________________________________________________________________________

Person ____ Firm ____ Corporation ____ Joint-stock co. ____ Syndicate ____ Assn _____

2. List all persons, firms, corporations, joint-stock companies, syndicates or associations having

at least a 5% ownership interest in the business (attach additional sheet, if needed).

__________________________________________________________________________

3. What is your present home address? _____________________________________________

__________________________________________________________________________

4. Previous address(es) within the last 10 years. ______________________________________

__________________________________________________________________________

5. Date of birth ____________

Home telephone _________________

Business telephone _____________ Fax Number_________________

e-mail address _____________________________________________

6. Under what name will this business operate? ______________________________________

__________________________________________________________________________

7. Location of business by street address or other geographical description and phone number of

the business. _______________________________________________________________

__________________________________________________________________________

8. Specify the identity and address of the person to receive annual privilege tax notices and any

other communication from the City. _____________________________________________

__________________________________________________________________________

9. Give name and address of property owner, if other than business owner. _________________

__________________________________________________________________________

10. Will permit be used to operate two or more restaurants or other businesses under the same

permit as permitted by Section 57-5-103(a)(4) within the same building? Yes ___ No ___. If

so, specify number _____. List the names of the restaurants or other businesses and describe

their locations.(use additional sheet if necessary) ___________________________________

Application For A Beer Permit Form