Fillable Application For Occupational License - Town Of Iowa, La (Page 3 of 3) in pdf

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TOWN OF IOWA (1756) BEER AND LIQUOR LICENSE APPLICATION

**If you need to obtain a beer and or liquor license please complete this application and return along with your occupational license

application and payment**

NAME

RDS Account Number:

ADDRESS

CITY

STATE

ZIP

Your annual Alcoholic Beverage Licenses are due on or before January 1st. Your remittance should be submitted along with a signed copy of

this form for the purpose of obtaining your annual Town of Iowa Alcoholic Beverage License. Your annual license expires at MIDNIGHT ON

December 31th.

a) Persons holding permits as dealers in beverages of high alcoholic content fails to file the application and pay the permit fee by

March 1, shall be subject to penalties as provided by state law, a delinquency penalty of five percent if the failure is for not more than 30

days with an additional five percent for each additional 30 days or fraction thereof during which the failure continues.

b) Persons holding permits as dealers in beverages of low alcoholic content will incur a delinquency penalty of 25% over and above the

regular fee.

HIGH ALCOHOLIC CONTENT BEVERAGES DEFINITIONS:

“

Beverages of high alcoholic content” means alcoholic beverages containing more than six percent alcohol by volume.

LOW ALCOHOLIC CONTENT BEVERAGES DEFINITIONS:

“Beverages of low alcoholic content” means alcoholic beverages containing not more than six percent alcohol by volume.

HIGH ALCOHOLIC BEVERAGES FEES:

Class A Retail- Consumable High Alcohol ($100.00) $_____________________

Class B Retail-Consumable Beer High ($35.00)

$_____________________

Penalty: (If filed March 1st or after) 5% of tax

_____________________

due for each 30 days or fraction thereof for

LOW ALCOHOLIC BEVERAGES

Class A Retail-Package Low Alcohol ($50.00)

$_____________________

Class B Retail-Package Beer Low ($25.00)

$_____________________

Penalty: (If filed March 1st or after) 25%

_____________________

in addition to regular license fee

TOTAL REMITTANCE:

$_____________________

Returned Check Disclaimer: Effective July 1, 2010, each returned item received by RDS due to insufficient funds will be electronically represented to the presenters’ bank no more than

two times in an effort to obtain payment. RDS is not responsible for any additional bank fees that will accrue due to the resubmission of the returned item. Please see the full returned

check policy at

Signature of Applicant: _______________________________________________Title:_______________________________ Date_________________

Print Name of Applicant: ______________________________________________Telephone: ______________________________________________