Form Il 567-0059 - Application For State Of Illinois Non-Resident Dealer'S Liquor License

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Illinois Liquor Control

Pat Quinn

Commission

Governor

100 W. RANDOLPH ST.

101 W. JEFFERSON ST.

SUITE 7-801

SUITE 3-525

CHICAGO, ILLINOIS 60601

SPRINGFIELD, ILLINOIS 62702

TELEPHONE: 312-814-2206

TELEPHONE: 217-782-2136

FAX: 312-814-2241

FAX: 217-524-1911

TDD: 312-814-1844

WEB SITE:

APPLICATION FOR STATE OF ILLINOIS

NON-RESIDENT DEALER’S LIQUOR LICENSE

DEFINITIONS

A Non-resident Dealer’s license shall permit such licensee to ship into and warehouse alcoholic liquor in this State from any point outside

of this State, and to sell such alcoholic liquor to Illinois-licensed foreign importers and importing distributors and to no one else in this

State; provided that said Non-resident Dealer shall register with the Illinois Liquor Control Commission each and every brand of alcoholic

liquor which it proposes to sell to Illinois licensees during the license period; and further provided that it shall comply with all of the

provisions of Section 6-9 of the Liquor Control Act with respect to registration of such Illinois licensees as may be granted the right to sell

such brands at wholesale. Please note that you must appoint an Illinois-licensed distributor (see page 3).

If you have agents, representatives or persons acting on your behalf in Illinois that sell or discuss pricing terms of alcoholic liquor

you are required to register each of these individuals by submitting forms IL 567-0053 “Application for Registration - Manufacturer’s

Registered Agent”, and IL 567-0054 “Statement of Representation - Registration of Manufacturer’s Agent”.

Currently licensed Illinois manufacturer - Class 1- Distiller, Class 2- Rectifier, or Class 3-Brewer.

FEE: NONE

Non-resident dealer who is a manufacturer of less than 500,000 gallons per year combined plant total, or agent

thereof AND/OR Primary U.S. Importer exporting less than 500,000 gallons into Illinois yearly, or agent thereof.

FEE: $90.00

Non-resident dealer who is a manufacturer of 500,000 gallons or more per year combined plant total, or agent

thereof AND/OR primary U.S. importer exporting 500,000 gallons or more into Illinois yearly, or agent thereof.

FEE: $270.00

Please include the following REQUIRED supporting documents:

• The

enclosed

Registration Statement;

• The following U.S. Department of the Treasury Tax and Trade Bureau applicaton forms (please visit the

TTB website at or call 1-877-882-3277 or for further information regarding these forms):

a) A copy of the Label Approval. Visit

to download the F 5100.31 application form;

b) A copy of the Basic Permit. Visit

to download the F 5100.24 application form;

• The

enclosed

Schedule L (RL-26-L) from the Illinois Department of Revenue (please call IDOR at

217-785-2622 should you require further assistance);

• The

enclosed

Application for Registration – Manufacturer’s Registered Agent (if applicable*);

• The

enclosed

Statement of Representation – Registration of Manufacturer’s Agent (if applicable*).

*If you have agents, representatives or persons acting on your behalf in Illinois that sell or discuss pricing terms

of alcoholic liquor, you are required to register each of these individuals by submitting the above two forms.

IMPORTANT NOTICE: THE ILLINOIS LIQUOR CONTROL COMMISSION IS REQUESTING DISCLOSURE OF INFORMATION THAT IS NECESSARY UNDER THE ILLINOIS LIQUOR CONTROL ACT

(235 ILCS 5/1 ET SEQ.). DISCLOSURE OF THIS INFORMATION IS MANDATORY. FAILURE TO PROVIDE ANY INFORMATION WILL RESULT IN THE NON-ISSUANCE OF YOUR LICENSE. FORM

APPROVED BY THE STATE FORMS MANAGEMENT CENTER.

IL 567-0059 (03/2006)

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