Form Abc-803 - Escrow Bond For Liquor Licenses Issued Under The Liquor Control Act
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1Kansas Department of Revenue
Alcoholic Beverage Control Division
915 S.W. Harrison Street, Room 214
Topeka, KS 66625-3512
Phone: 785-296-7015 Fax: 866-855-5025
ESCROW BOND
FOR LIQUOR LICENSES ISSUED UNDER THE LIQUOR CONTROL ACT
Pursuant to K.S.A. 41-317
KNOW ALL MEN BY THESE PRESENTS:
That we ________________________________ and ________________________________ do hereby enter into
(Depositor)
(Escrow Agent)
this agreement in compliance with K.S.A. 41-317(b) and K.A.R. 14-7-4.
WHEREAS, the Depositor has applied for or has been licensed by the Director of the Alcoholic Beverage Control
Division of the State of Kansas as a:
Retailer
Beer Distributor
Spirits Distributor
Wine Distributor
Farm Winery
Microbrewery
Microdistillery
Manufacturer
Non-Beverage User
Special Order Shipping
Depositor agrees to purchase and deliver to Escrow Agent a certificate of deposit issued by a Kansas bank or
savings and loan association in the amount of $__________, which is the amount established by Kansas law as the
required bond. Depositor shall not assign, transfer, alienate, pledge as security for any loan, or otherwise encumber
the certificate during the period of this agreement.
Escrow Agent acknowledges receipt of the certificate of deposit numbered ___________________ and shall not
return said certificate to Depositor nor permit said certificate to be assigned, transferred, alienated, pledged, or
otherwise encumbered during the period of this agreement except as provided below. Escrow Agent shall remit interest
on the certificate annually to Depositor.
Upon written demand from the Director of the Alcoholic Beverage Control, should Depositor default in payment of
any fees, fines or taxes to the Kansas Department of Revenue, Escrow Agent shall remit the value of the certificate and
any unpaid interest accrued through the date of notification to the Alcoholic Beverage Control. Upon remittance, this
agreement shall be deemed terminated.
Upon written notice from the Director of the Alcoholic Beverage Control that a bond is no longer required for
Depositor, Escrow Agent shall release the certificate to Depositor. This agreement shall terminate upon such release.
Nothing in this agreement shall be construed to increase Escrow Agent’s liability beyond the amount of the
certificate and the express provisions of this agreement.
This bond shall be effective on and after the __________ day of ___________________, _________, unless
(Day)
(Month)
(Year)
terminated as specified above.
Witness our hands at ____________________, ________, this _______ day of ________________, __________.
(City)
(State)
(Day)
(Month)
(Year)
ESCROW AGENT
(please print)
Signature of Escrow Agent
Escrow Agent’s Name
Mailing Address
Area Code and Phone Number
DEPOSITOR or AGENT
(please print)
Signature of Depositor or Agent
Title of Depositor
Depositor or Agent Name
Mailing Address
Area Code and Phone Number
NOTARY
Subscribed and sworn to before me this ___________ day of _______________, _______
_____________________________________
Notary
Public
My commission expires:
_________________________
For ABC Office Use Only
Bond Demand
License Number(s):
Rep’s Initials:
Date:
Rep’s Initials:
Amount $
FEIN:
Date:
Bond Release
Date:
Rep’s Initials:
ABC-803 (Rev. 8.1.12)
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