Form Abc-1000 - Supplier Permit Fee Voucher
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2Kansas Department of Revenue
Alcoholic Beverage Control Division
915 S.W. Harrison Street, Room 214
Topeka, KS 66625-3512
Phone: 785-296-7015 Fax: 785-296-7185
Supplier Permit Application and Agreement Instructions
Requirements to Obtain a Kansas Supplier Permit:
A.
Supplier Permit Application and Agreement (ABC-1000).
B.
$25.00 Supplier Permit Fee.
C. Copy of your Basic Permit or Brewer’s Notice.
D. If your company is not located in Kansas, you are you are required to file the Irrevocable Consent to Jurisdiction
form (ABC-160) with the Kansas Secretary of State. The Secretary of State’s Office will return to you a copy of
the ABC-160 form that has been stamped “FILED”. You must then provide the ABC with a copy that has been
stamped “FILED” along with the items listed above.
Instructions to Complete the ABC-1000 Supplier Permit Application and Agreement:
1.
Permit Type.
a.
New Permit. Check the “New Permit” box if you do not have a Kansas Supplier Permit or if your Kansas
Supplier Permit has been expired for more than 30 days.
b.
Renew Permit. Check the “Renew Permit” box to renew your current Kansas Supplier Permit.
2.
Answer the questions. If you answer yes to either question, a Salesperson’s Permit must be obtained for the
person in Kansas soliciting sales from Kansas liquor licensees.
3.
Check the appropriate “Application Entity Type”, complete, sign and date the Supplier Permit Application and
Agreement form, print your name and title.
4.
Make a copy of the completed Supplier Permit Application and Agreement. Retain the copy for your records.
This will serve as your permit.
5.
Complete the attached Supplier Permit Voucher.
a.
New Permit. Check the “New Permit” box, enter the name as it appears on the Supplier Permit Application
and Agreement and check the box to indicate your $25 Permit Fee is attached. Answer the questions in the
“New Permits Only” section.
b.
To Renew Permit. Check the “Renew Permit” box, enter your Supplier Name, Supplier Permit Number and
check the box to indicate your $25 Permit Fee is attached.
6.
Make your check payable to the “Kansas Department of Revenue” and attach it to the completed Supplier Permit
Voucher below.
7.
Return the original completed Supplier Permit Agreement, a copy of your Basic Permit or Brewer’s Notice and
$25.00 Supplier Permit fee to the ABC Marketing Unit. Out-of-state applicants, who are applying for a new
permit, must include a filed copy of the Irrevocable Consent to Jurisdiction (ABC-160).
All approved Supplier Permits are posted to the ABC Active Liquor Licensee Database on the ABC website. To view
your permit information, go to: https://
To
obtain
monthly
Supplier
reporting
forms
and
other
information,
visit
our
website
at:
Direct your questions to the Marketing Unit at 785-296-7015 or email to ABC.Marketing.Unit@kdor.ks.gov
Detach and Return with Payment
KANSAS ALCOHOLIC BEVERAGE CONTROL DIVISION
Supplier Permit Fee Voucher
Supplier DBA Name:
New Permit
Attach the following documents:
Copy of your Federal Basic Permit or Brewer’s Notice
Copy of your filed Irrevocable Consent to Jurisdiction (ABC-160)
Not required (Company is located in Kansas)
$25.00 Permit Fee Enclosed (SLFE)
Renew Permit Number: 19 -
$25.00 Permit Fee Enclosed (SLFE)
ABC-1000 (Rev. 7.19.13)
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Parent category: Financial