Form Dbpr Abt-6011 - Application For Caterer'S License

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DBPR ABT-6011 –Division of Alcoholic Beverages and Tobacco Application for Caterer’s License
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL
REGULATION
1940 North Monroe Street
Tallahassee, FL 32399-0783
NOTE – This form must be submitted as part of an
application packet
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 - CHECK TRANSACTION REQUESTED
Transaction Type:
Initial Permanent License
Do you wish to purchase a Temporary License?
Correction
Yes
No
SECTION 2 - LICENSE INFORMATION
If the applicant is a corporation or other legal entity, enter the name as registered with the Secretary of State
on the line below.
Full Name of Applicant
Corporate Document # _______________________
Trade Name (D/B/A)
FEIN Number or Social Security Number*
Location Address (Street and Number)
City
County
State
Zip Code
Mailing Address (Street or P.O. Box)
City
State
Zip Code
Resident Agent/Contact Person
Phone Number
Street Address
City
State
Zip Code
Does the applicant entity currently hold an alcoholic beverage license?
Yes
No
If yes, complete the following information.
Current License Number
Series
Type
Current Business Name
1

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