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Form Dbpr Abt-6016 - Division Of Alcoholic Beverages And Tobacco Application For Vehicle Permit

DBPR ABT-6016 – Division of Alcoholic Beverages and Tobacco Application for Vehicle Permit

STATE OF FLORIDA

DEPARTMENT OF BUSINESS AND PROFESSIONAL

REGULATION

1940 North Monroe Street

Tallahassee, FL 32399-0783

If you have any questions or need assistance in completing this application, please contact the

Department of Business and Professional Regulation or your local district office. Please submit your

completed application to your local district office. This application may be submitted by mail, through

appointment, or it can be dropped off. A District Office Address and Contact Information Sheet can be

found on AB&T’s page of the DBPR web site at the link provided below

SECTION 1 - APPLICANT INFORMATION

Business Name

Licensee Name

Location Address

City

County

State

Zip Code

SECTION 2 - VEHICLE INFORMATION

Make of Vehicle

Model

Year

Vehicle Identification Number

Vehicle Tag Number

SECTION 3 - AFFIDAVIT OF APPLICANT

NOTARIZATION REQUIRED

I, the undersigned individual, or if a corporation for itself, its officers and directors, hereby swear or affirm

that the referenced vehicle is owned or leased by the above entity and will be used to make deliveries of

sales actually made at my licensed premises, or to transport alcoholic beverage purchases from a

distributor’s licensed place of business to my licensed premises or authorized off-premises storage facility.

Further, I understand that this permit is valid and will not expire unless the vehicle is disposed of, or my

alcoholic beverage license is transferred, cancelled, not renewed, or revoked by the Division. I further

agree that such vehicle is subject to be inspected and searched without a search warrant during business

hours or other times the vehicle is being used to transport or deliver alcoholic beverages by officers of the

Division of Alcoholic Beverages and Tobacco, the sheriff, his deputies, and police officers for the purpose

of ascertaining compliance with the beverage laws.

STATE OF___________________

_________________________________________________

APPLICANT SIGNATURE

COUNTY OF_________________

_________________________________________________

APPLICANT SIGNATURE

The foregoing was ( ) Sworn to and Subscribed OR ( ) Acknowledged Before me this __________Day

of_____________, 20______, By__________________________ who is ( ) personally known to me

OR ( ) who produced ____________________________ as identification.

__________________________________________ Commission Expires:

Notary Public

Form Dbpr Abt-6016 - Division Of Alcoholic Beverages And Tobacco Application For Vehicle Permit

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