Form Abc-830 - Temporary Permit Application And Agreement Instructions (Page 6 of 6) in pdf

Kansas Department of Revenue

Alcoholic Beverage Control Division

915 S.W. Harrison Street, Room 214

Topeka, KS 66625-3512

Phone: 785-296-7015 Fax: 785-296-7185

Applicant or Organization Name________________________________________ Event Date(s)________________________

The above named applicant or organization, does hereby make application for a Temporary Permit to sell alcoholic liquor on the

specified date(s) and location. In making this application, the above named applicant agrees that:

They will display the Temporary Permit at the event entrance along with the name of the designated person of the organization

who is in charge, a diagram of the premises covered by the permit; and, if a special event, they must include names of all

drinking establishments who have elected to extend their licensed premises into the event.

They will not allow anyone under the age of 21 to possess, purchase or consume alcoholic liquor and understand that

administrative and/or criminal penalty may result from allowing anyone under the age of 21 to possess or consume alcoholic

liquor.

They will not deny immediate entry and inspection by the Alcoholic Beverage Control agents or other law enforcement officers.

On-Premise applicants must purchase their alcoholic liquor from a licensed Kansas Retailer who possesses a Federal

Wholesale Liquor Dealer permit or from a licensed Kansas Farm Winery.

On-Premise applicants will retain sales receipts from the Kansas Retailer or Kansas Farm Winery for at least one year.

On-Premise applicants will not sell alcoholic liquor for less than the purchase price or for less than the price charged for that

drink to all other persons on that day.

On-Premise applicants will complete and submit their Business Tax Application and collect Liquor Drink tax, file the Liquor

Drink tax return and remit the tax due by the 25

of the following month.

On-Premise applicants will not allow consumption of alcoholic liquor between the hours of 2:00 a.m. and 9:00 a.m.

They will comply with applicable city and county laws; and, with all the provisions of the Kansas Liquor Control Act, Club and

Drinking Establishment Act and the Rules and Regulations promulgated thereunder

________________________________________

Authorized Signature

Date

________________________________________

Printed Name

Printed Title

ABC Office Use Only:

PERMIT FEE ENCLOSED Amount $_________ Associate: ___________________________ Date_________________________________

APPROVED Date:_________________________ Associate: ___________________________ Permit #______________________________

DENIED Date_____________________________ Associate:___________________________

Denial Letter Sent Date_______________

Clear Form

ABC-830 (Rev. 7.1.12)

Page 6 of 6

Form Abc-830 - Temporary Permit Application And Agreement Instructions Page 6