Form Abc-800 - Kansas Liquor License Application Instructions Page 5
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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
FEIN_______________________
SECTION 2 – BUSINESS LOCATION INFORMATION
Check One:
New License
License Type: _____________________________________
Location Information
Renew License No. _____________________________________________
Location DBA Name
Location Street Address
City
County
State
Zip
Business Phone No.
E-Mail Address
Check One:
New License
License Type: _____________________________________
Location Information
Renew License No. _____________________________________________
Location DBA Name
Location Street Address
City
County
State
Zip
Business Phone No.
E-Mail Address
Check One:
New License
License Type: _____________________________________
Location Information
Renew License No. _____________________________________________
Location DBA Name
Location Street Address
City
County
State
Zip
Business Phone No.
E-Mail Address
Check One:
New License
License Type: _____________________________________
Location Information
Renew License No. _____________________________________________
Location DBA Name
Location Street Address
City
County
State
Zip
Business Phone No.
E-Mail Address
Check One:
New License
License Type: _____________________________________
Location Information
Renew License No. _____________________________________________
Location DBA Name
Location Street Address
City
County
State
Zip
Business Phone No.
E-Mail Address
Check One:
New License
License Type: _____________________________________
Location Information
Renew License No. _____________________________________________
Location DBA Name
Location Street Address
City
County
State
Zip
Business Phone No.
E-Mail Address
ABC-800 (Rev. 7.1.12)
Page 5 of 13
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