Amendment Application For A Change Of Beneficial Interest Or Transfer/issuance Of Stock - Massachusetts Alcoholic Beverages Control Commission Page 2

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The Commonwealth of Massachusetts
Alcoholic Beverages Control Commission
239 Causeway Street
Boston, MA 02114
AMENDMENT APPLICATION FOR A CHANGE OF BENEFICIAL INTEREST,
CHANGE IN OFFICERS or DIRECTORS FOR NOT-FOR-PROFT CLUBS, OR
TRANSFER/ISSUANCE OF STOCK
The following documentation is required as a part of your retail license amendment application.
ABCC investigators reserve the right to request additional documents as a part of their investigation.
Monetary Transmittal Form
with $200 fee
You can
PAY ONLINE
or include a $200 check made out to the ABCC
Change of Beneficial Interest Amendment Application (this packet)
Beneficial Interest - Individual Form
(formerly known as the Personal Information Form)
For any individual with direct or indirect interest in the proposed licensee
Beneficial Interest - Organization Form
For any organization with direct or indirect interest in the proposed licensee
CORI Authorization Form
For any individual with direct or indirect interest in the proposed licensee. This form must
be notarized with a stamp*
Vote of the Corporate Board
A corporate vote changing the beneficial interest holders, signed by an authorized signatory
for the licensed entity
Business Structure Documents
If Proposed Licensee is applying as:
- A Corporation or LLC - Articles of
Organization from the Secretary of the
Commonwealth
- A Partnership - Partnership Agreement
- Sole Proprietor - Business Certificate
Supporting Financial Documents
Documentation supporting any loans or financing, if applicable
Additional Documents Required by the Local Licensing Authority
*Officers/Directors of non-profit clubs with no ownership do not need to fill out CORI applications

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