Off-Premises Liquor License Application - Montana Department Of Revenue (Page 2 of 2) in pdf

Off-Premises Liquor License Application - Montana Department Of Revenue Page 2

Section 3: Temporary Authority

The undersigned, requests authority to operate pending ﬁ nal approval of the license. Temporary authority may be granted to an

applicant by the Department of Revenue if the current premises has been licensed in the past year for the sale of alcohol and no

building, health, or ﬁ re deﬁ ciencies exist. The undersigned agrees that during the period of temporary operating authority, the applicant

shall be responsible for all beer and wine purchased pursuant to Section 16-3-243, MCA (the seven-day credit limitation). I realize

temporary authority will be immediately revoked if my employees or I violate any provisions of Title 16, MCA or the departments rules.

Temporary authority cannot be granted for a transfer of location.

I would like temporary authority issued on ________________ (Date)

Section 4: Notice To Applicants

In order for your application to be considered complete you must include all associated or related documents as indicated by your

speciﬁ c circumstance in the accompanying check sheet. Processing a license application takes approximately two (2) to three (3)

months based upon the Department’s determination of receipt of a complete application, if no deﬁ ciencies are received. You will be

notiﬁ ed when a decision regarding the application has been made.

Section 5: Declaration and Afﬁ davit

This application must be signed by the applicant or by a duly authorized representative of the entity submitting this application. The

person who signs this application attests that the information contained in the application is correct and complete. Montana law says

“Upon proof that an applicant made a false statement in any part of the original application, in any part of an annual renewal application,

or in any hearing conducted pursuant to an application, the application for the license may be denied, and if issued, the license may be

revoked.” (Section 16-4-402, Montana Codes Annotated)

________________________________________________

_______________________________________________

Signature

Date

________________________________________________

_______________________________________________

Printed Name

Title

Section 6: Corporate Statement (includes Corporations, LLC’s, LLP’s and Partnerships)

The stockholders/members/partners are:

Social Security

Number of

Name

Address

Date of Birth

Number

Total Shares:

Ofﬁ cers and Directors of the Corporation are:

Name

Address

Title

offprem00

Revised 05-06

Off-Premises Liquor License Application - Montana Department Of Revenue Page 2