Montana Form Avp-2 - Liquor Division Application For Vendors Permit - Department Of Revenue
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3MONTANA
Form AVP-2
Clear form
Rev. 8-06
Liquor Division
Application for Vendors Permit
$ _________________
Permit Fee - $100
Under the provision of Title 16 of the Montana Codes Annotated and the Administrative Rules of Montana
42.11.201 through 42.11.252, the undersigned hereby makes application for a Montana Vendors Permit.
Name of Applicant (Firm or Corporation) ______________________________________________________
Address ___________________________________________________ Phone ______________________
We understand to be registered as a vendor we must register at least one (1) Montana resident as our
representative (see below).
We have read and understand the rules adopted by the Department of Revenue, Liquor Division and agree
to abide by all laws and rules of the State of Montana regarding the promotion of alcoholic beverages.
_____________________________________________
Mail to:
Signature - Vendors Authorized Official or Broker
Registration and Licensing
_________________________
_________________
PO Box 1712
Helena, MT 59604-1712
Title
Date
Permit Fee of $100 Must Accompany This Application
For Registration of Representative
$ _________________
$25 Fee For Each Representative
Having made application above, or being a holder of Montana Vendors Permit No. ___________________
understand that we are required to employ at least one, but not more than three (3), representatives to
promote the sale of our liquor products in the State of Montana. We therefore request approval to register
the following as representative(s) for ________________________________________________________
______________________________________________________________________________________
Individual or Firm Name
1. Name ______________________________________________________________________________
Address _______________________________________________ Phone ______________________
2. Name ______________________________________________________________________________
Address _______________________________________________ Phone ______________________
3. Name ______________________________________________________________________________
Address _______________________________________________ Phone ______________________
_____________________________________________
Mail to:
Signature - Vendors Authorized Official or Broker
Registration and Licensing
PO Box 1712
_________________________
_________________
Helena, MT 59604-1712
Title
Date
Complete Statement of Representative on back.
This application must be accompanied by the $25 filing fee for each Representative.
563
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