Form Abc 289 - Alcoholic Beverage Control Division printable pdf download

KANSAS DEPARTMENT OF REVENUE

ALCOHOLIC BEVERAGE CONTROL DIVISION

Management Services Disclosure Form

Licensee Name

License Number

Address

Phone Number (

)

City

State

Zip Code

The Kansas Liquor Control Act prohibits corporate ownership of a retail liquor store. Furthermore, it prohibits any person

who has a beneficial interest in any other retail establishment licensed under the Act - or in the manufacture, preparation

or wholesaling of alcoholic beverages - from being issued a liquor retailer's license, unless such beneficial interest is derived

through the person's spouse also owning and holding a retailer's license. A "beneficial interest" is defined as "any ownership

interest by a person or that person's spouse in a business, corporation, partnership, trust, association or other form of

business organization which exceeds 5% of the outstanding shares of that corporation or a similar holding in any other form

of business organization." K.A.R. 14-13-1(c). Deriving a percentage of gross receipts from any other business involving

alcoholic liquor also constitutes a beneficial interest. Certain guidelines and restrictions exist to ensure compliance with

the legislative intent that there not be any corporate owned stores and that no licensee has a beneficial interest in more

than one business involving alcoholic liquor. Accordingly, PLEASE ANSWER THE FOLLOWING:

Will any person/entity other than the owner(s) or partners be engaged or contracted to perform management or operational

services to the retail liquor store? ("Performance of management or operational services" means the exercise of control by

any person(s) or entity other than the owner(s) or partners of a retail liquor store - but for or on behalf of the store or its

owner(s) or partners - over the: hiring, firing and/or supervising of employees; types or levels of inventory ordered or kept

on hand by the store; placement of inventory orders for or coordination of inventory deliveries to the store; advertising,

marketing or promotional programs enlisted, offered or utilized by the store; negotiating, entering into and/or execution of

contracts to which the store is a party; payment or authorization to pay for services provided to or purchases made by the

store; and performance of any other, similar task(s) central to the operation of or ability to operate the store.)

If no, sign and date this form (see below), and return it along with your application.

Yes

If yes, you MUST attach to this form any agreement and/or contract regarding such management or operational

services, or if no written agreement and/or contract exists or will be entered into, supply the terms of any

arrangement by which such management or operational services will be provided. In addition, you MUST

complete and return Forms 290 and 291, providing all required information of the person/entity who will

perform such management or operational services. Then sign and date this form below.

Signature

Date

ABC 289 (11/2001)

Form Abc 289 - Alcoholic Beverage Control Division