Form Il 567-0015-A - Application For State Of Illinois Distributor/ Importing Distributor/foreign Importer Liquor License Page 17
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17Step 2: Identify each temporary location
Examples include a fair, festival, or special event. Seasonal sales (i.e., trade-shows, holiday sales, concession stands) are usually consid-
ered a temporary location.
DBA name:____________________________________________
DBA name:____________________________________________
Address: _____________________________________________
Address: _____________________________________________
Street address - No PO Box numbers
Apt. or suite no.
Street address - No PO Box numbers
Apt. or suite no.
_____________________________________________
_____________________________________________
City
State
ZIP
City
State
ZIP
County:______________________ If located within Madison or
County:______________________ If located within Madison or
St. Clair county, tell us your township: _______________________
St. Clair county, tell us your township: _______________________
Contact: ____________________ Phone: (____)____ - _______
Contact: ____________________ Phone: (____)____ - _______
Starting date for this location: ____/____/_______
Starting date for this location: ____/____/_______
Sales and use
Telecommunications service
Sales and use
Telecommunications service
Vehicle sales
Vehicle sales
Other: ___________________________________________
Other: ___________________________________________
Check here if your business activities are seasonal or for a
Check here if your business activities are seasonal or for a
special event. Provide the following dates.
special event. Provide the following dates.
Starting: ____/____/_______
Ending: ____/____/_______
Starting: ____/____/_______
Ending: ____/____/_______
DBA name:____________________________________________
DBA name:____________________________________________
Address: _____________________________________________
Address: _____________________________________________
Street address - No PO Box numbers
Apt. or suite no.
Street address - No PO Box numbers
Apt. or suite no.
_____________________________________________
_____________________________________________
City
State
ZIP
City
State
ZIP
County:______________________ If located within Madison or
County:______________________ If located within Madison or
St. Clair county, tell us your township: _______________________
St. Clair county, tell us your township: _______________________
Contact: ____________________ Phone: (____)____ - _______
Contact: ____________________ Phone: (____)____ - _______
Starting date for this location: ____/____/_______
Starting date for this location: ____/____/_______
Sales and use
Telecommunications service
Sales and use
Telecommunications service
Vehicle sales
Vehicle sales
Other: ___________________________________________
Other: ___________________________________________
Check here if your business activities are seasonal or for a
Check here if your business activities are seasonal or for a
special event. Provide the following dates.
special event. Provide the following dates.
Starting: ____/____/_______
Ending: ____/____/_______
Starting: ____/____/_______
Ending: ____/____/_______
Step 3: Identify each changeable location
A changeable location is one that constantly changes (i.e., door-to-door sales, home party sales).
DBA name:____________________________________________
DBA name:____________________________________________
Municipality:___________________________________________
Municipality:___________________________________________
County:______________________ If located within Madison or
County:______________________ If located within Madison or
St. Clair county, tell us your township: _______________________
St. Clair county, tell us your township: _______________________
Starting date: ____/____/_______
Starting date: ____/____/_______
Schedule REG-1- L (N-11/07)
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