Form Tp-125 - Application For Temporary License To Import Liquors For Personal Use And Consumption
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2TP-125
New York State Department of Taxation and Finance
Application for Temporary License to Import
(1/03)
Liquors for Personal Use and Consumption
(Submit this application not more than 30 days prior to use.)
Applicant’s social security number
Age
Last name
First
Middle initial
Street address
City
State
ZIP code
Country
Telephone number
(
)
Dates for which license is requested (license is valid for 14 days): From
to
Quantity of liquor expected to be imported on this license
:
(in liters)
Quantity of liquor imported in the previous 12-month period:
Number of licenses requested in the previous 12-month period:
Identification type code
:
(see back)
Transporter information (if
other than applicant)
Transporter name
State Liquor Authority (SLA) Transporter number
(if applicable)
Street address
City
State
ZIP code
Country
Method
Destination of liquor
(if applicant’s address, enter same)
Name
Street address
City
State
ZIP code
Country
Telephone number (
)
Supplier information
(if known at time of application)
Name
Street address
City
State
ZIP code
Country
Telephone number (
)
Check one box:
State only
New York City only
State and city
I hereby declare that I am 21 years of age or older and that this application has been made with the knowledge that a willingly
false representation is a crime under Article 37, section 1813, of the New York State Tax Law punishable by fines and penalties
stipulated therein, and affirm that the statements are true, correct, and complete.
Signature of applicant
Date
— Submit a picture ID with this application.
— If you import more than 360 liters of liquors in a one-year period, you must register as a distributor of liquors, using
Form TP-215 instead of completing this application.
See back of this application.
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