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Form Abc-1020 - Kansas Microbrewery - Application For Brand Registration And Label Approval Page 5

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

SECTION 3 – KANSAS MICROBRWERY BRAND REGISTRATION AND LABEL APPROVAL REQUEST

20 - __ __ __ - __ __ __ __ - __ __

License Number

(Division Use Only)

CONTAINER INFORMATION

BRAND NAME

LABEL DESCRIPTION

APPROVAL

DATE &

PKG

S.U.

SIZE

TYPE*

INITIALS

*DISTRIBUTION TYPE – Enter the letter code in the “DISTRIBUTION TYPE” field above:

***CONTAINER TYPE–Enter the appropriate abbreviation

MB = This product can only be sold at the Microbrewery for off-premise consumption.

in the “CONTAINER TYPE” field above or add your own

D = This product can only be sold for distribution by a licensed Kansas Beer Distributor. (Requires

abbreviation and provide explanation. EXAMPLES:

franchise greement and state map).

BTL = Bottle

B = Product can be sold for distribution and off-premise consumption.

CAN

KEG

**PRODUCT TYPE

GR = GROWLER

3 = Domestic Beer (greater than 3.2%ABW – but no more than 10%ABW)

ABC-1020 (Rev. 7.1.11)

Page 5 of 5

Form Abc-1020 - Kansas Microbrewery - Application For Brand Registration And Label Approval Page 5