Form B-0188 - Application For Permit To Sell Alcoholic Beverages
ADVERTISEMENT
1
2
3ALCOHOLIC BEVERAGE COMMISSION
rd
500 James Robertson Parkway, 3
Floor
4420 Whittle Springs Road
Nashville, TN 37423
Knoxville, TN 37917
615-741-1602
865-594-6342
One Commerce Square
540 McCallie Avenue, Suite 341
40 South Main St.
Chattanooga, TN 37402-2055
th
4
Floor, Suite 415
423-634-6434
Memphis, TN 3103
901-543-7284
Business Check, Money Order or Cashier’s Check ONLY
APPLICATION FEE
APPLICATION FOR PERMIT TO SELL
ALL signature spaces MUST be
signed and notarized
NON-REFUNDABLE
ALCOHOLIC BEVERAGES
RETAIL FOOD STORE
Date: ___________________, 20______
Name of Corp./LLC/LP, person, etc.:_______________________________________________________________
hereby makes application for a permit to sell wines with an alcohol content less than 18% at the following location.
Doing Business As: _____________________________________________________________________________
Business Address: ______________________________ Business Tel: (____) ___________ Fax: (___) __________
City: ___________________________ State: ___________ Zip Code: ______________ County: _______________
Mailing Address
(if different): ________________________________________________________________________________________
Street Address
City
State
Zip
Email Address: ______________________________________ Web Site Address: __________________________
1. Are you, and all principals of applicant, United States Citizens or legally residing in the United States? ___________ All
applicants, and principals of applicant, must complete Form AB-0116- Declaration of Citizenship.
2. Have you or any other person having any direct or indirect interest in the applicant ever been convicted of any criminal
offense under the laws of the State of Tennessee, of any other State or of the United States prohibiting, regulating the sale,
possession, transportation, storing, manufacturing or otherwise handling intoxicating liquors or any other felony offense
within ten (10) years preceding the date of this application? ________ If yes, please explain on an additional sheet of
paper and attach.
3. Have you or any other person having any direct or indirect interest in the applicant ever been cited to appear before the
Commissioner of Revenue or the Tennessee Alcoholic Beverage Commission and charged with a violation of the law or
rules and regulation made pursuant to law? _______________________________________________________________
4. In whose name is the Alcohol Dealer Registration (TTB F 5630.5d) as a retail dealer (retail wine in food store) issued for
this location? ______________________________________________________________________________________
AB-0188
RDA 2261
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Bt-100 - Application For Permission To Import Alcoholic Beverages From Within The United States For Personal Consumption
Legal
Form Bt-101 - Application For Permission To Import Alcoholic Beverages From Outside The United States For Personal Consumption
Legal
Form Rl-4 - Application For Permit To Purchase Alcoholic Liquors Tax Free For Nonbeverage Purposes
Financial
Form Rl-4 - Application For Permit To Purchase Alcoholic Liquors Tax Free For Nonbeverage Purposes - 1999
Financial
Form Rl-4 - Application For Permit To Purchase Alcoholic Liquors Tax Free For Nonbeverage Purposes
Financial
Form Ab-163 - Application For Transfer Of An Alcohol Beverage Permit From One Premise To Another
Financial
Related Categories
Parent category: Legal