Dbpr Form Abt-6003 - Division Of Alcoholic Beverages And Tobacco Application For One/two/three Day Permits Or Special Sales License Page 5

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This form is to be completed ONLY when the event of the non profit
organization is being held at a location that is licensed for the sale of alcoholic
beverages by the Division.
Note: This form must be signed by the permanent license holder and
submitted by the non-profit group along with the application for
One/Two/Three Day Permit.
Licensee:
Business Name:
License #
Series:
Name of Non-Profit Group:
Date(s) of Event:
I M P O R T A N T
A One/Two/Three Day permit is being requested for an event to be held on
your licensed premises. During the event, no sales or service of alcoholic
beverages may be made under your alcoholic beverage license. Failure to
comply will result in administrative charges being filed against your license.
Signature of Licensee
7

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