Form G-1 - Grocery Inventory printable pdf download

Form G-1 - Grocery Inventory

MONTANA

G-1

Rev 03-10

Grocery Inventory

A retail license to sell beer or table wine in the original package for off-premises consumption may only be

issued to a qualified applicant whose premises proposed for licensing is operated as a “bona fide grocery

store” or a drug store licensed as a pharmacy, Montana Code Annotated (MCA), 16-4-115(1). A “bona fide

grocery store” is defined in Administrative Rules of Montana, (ARM), 42.12.106 (2).

A retail inventory of $3,000 will be used as a basis to determine whether your establishment qualifies as a

“bona fide grocery store” and must be maintained at all times and have available at least three different types

of items in each of the food categories below.

Please list the three different types of food and household items from your retail inventory that you must sell for

consumption off-premises;

(Example of three food types in the meat category are: canned tuna, bologna or beef jerky; examples in the

vegetables category are: canned peas, fresh lettuce or frozen corn.)

Meats

______________________ ______________________ ______________________

Vegetables

______________________ ______________________ ______________________

Fruits

______________________ ______________________ ______________________

Bakery Items

______________________ ______________________ ______________________

Dairy Products

______________________ ______________________ ______________________

Household Supplies ______________________ ______________________ ______________________

Please enter the retail inventory dollar amount of your grocery inventory. $ _______________

I certify the retail inventory to be true, correct and complete.

__________________________________________________________

Business Trade Name

__________________________________________________________

County

__________________________________________________________

Date

__________________________________________________________

Signature

Form G-1

Form G-1 - Grocery Inventory