Form Abc-800 - Kansas Liquor License Application Instructions Page 4
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13Kansas Department of Revenue
Alcoholic Beverage Control Division
915 S.W. Harrison Street, Room 214
Topeka, KS 66625-3512
Phone: 785-296-7015 Fax: 866-855-5025
KANSAS LIQUOR LICENSE APPLICATION
SECTION 1 – BUSINESS ENTITY INFORMATION
Check one application type:
NEW LICENSE
(check one):
I have completed my Business Tax Application (KS-1216) and will submit with my liquor license application.
I have registered for my business taxes online.
https://
RENEW LICENSE(S)
EXPIRATION DATE:
Business Mailing Address for All Licenses
FEIN:
Business Entity Name
Contact Person Name
Business Mailing Address
City
State
Zip
Business Phone No.
E-Mail Address
*Social Security Number
Under the Federal Privacy Act, disclosure of a social security number in this application is voluntary. If no
social security number is disclosed for each person listed in this application, a state issued driver’s license
number or government issued identification card number must be provided. Any social security number
provided may be forwarded to the Department of Social and Rehabilitative Services in compliance with K.S.A.
39-758.
ABC OFFICE USE ONLY:
License Fee
Registration Fee
Associate Initials/Date
Full
Amount $____________________
$50 New License
$10 Renew License
st
1
Half
Amount $____________________
$50 New License
$10 Renew License
ALCOHOLIC BEVERAGE CONTROL DIVISION
LICENSE FEE VOUCHER
DBA Name:
TOTAL AMOUNT
License Number(s):
CLFE
$50 New License
Full License Fee:
$
Registration Fee: (CLPR)
$
CLPR
$10 Renewal
CLFE
$50 New License
st
1
Half License Fee:
$
Registration Fee: (CLPR)
$
CLPR
$10 Renewal
ABC-800 (Rev. 7.1.12)
Page 4 of 13
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