Dbpr Form Abt-6027 - Examination Application printable pdf download

DBPR ABT-6027 – Division of Alcoholic Beverages and Tobacco Application for Escrow of an Alcoholic

Beverage License

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

$35.00 processing fee must accompany your application

SECTION 1 - LICENSE INFORMATION

License Number

Series

Full Name of Applicant (if this is a corporation or other legal entity, enter the name as registered with the

Secretary of State)

Business Name (D/B/A)

Current Location Address

City

State

Zip Code

Mailing Address

City

State

Zip Code

Reason for Escrow Request

Anticipated Escrow Period

TO BE COMPLETED BY THE DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO

DISTRICT OFFICE PERSONNEL PRIOR TO BEING SIGNED BY APPLICANT

This license was issued or transferred to the applicant entity on or before September 30, 1988.

Therefore, as provided for in Section 561.29(1)(h), Florida Statutes failure to maintain licensed premises

in an active manner in which the licensed premises are open for the bona fide sale of authorized

alcoholic beverages during regular business hours of at least six (6) hours a day for a period of 120

days or more during any 12-month period, may result in this license being revoked or suspended.

This license was issued or transferred to the applicant after September 30, 1988. Therefore, as provided

for in Section 561.29(1)(i), Florida Statutes failure to maintain licensed premises in an active manner in

which the licensed premises are open for the bona fide sale of authorized alcoholic beverages during

regular business hours of at least eight (8) hours a day for a period of 210 days or more during any 12-

month period in a manner so as to maximize sales and tax revenues thereon, may result in this license

being revoked or suspended.

Applicant’s Initials:

Date:

Dbpr Form Abt-6027 - Examination Application