Form Abc-811 - Notice Of Intent To Sell
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1Kansas 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
NOTICE OF INTENT TO SELL
Name of Corporation, Individual, Partnership, LLC
DBA Name
Kansas Liquor License No.
___ ___ - ___ ___ ___ - ___ ___ ___ ___ - ___ ___
Location Address
City
State
Zip Code
Telephone Number
Email Address
Transaction Type: (check one)
Selling Business
Change Entity
I/We, _____________________________________________________________________________________
(MANAGING OFFICER OF CORPORATION OR LLC, OR ALL MEMBERS OF PARTNERSHIP, OR SOLE OWNER)
intend to sell the above listed business on or about ________________________________________________
(PROPOSED DATE OF SALE OR CHANGE)
to ______________________________________.
(BUYER)
I understand that I must complete the back of the license, sign (owner or officer signature) and return my
license to the ABC. (Does not apply if the business is sold 100% in tact).
I understand that all taxes must be paid, including any penalty and interest owed. If liquor taxes are not
paid, they will be deducted from my bond.
I understand that all liquor fines must be paid. If liquor fines are not paid, they will be deducted from my bond.
I understand my bond will be released upon completion of the above. If I have a cash bond, I must provide
the original receipt.
I/We hereby affirm that I/we will remain in active ownership and management control of the above named
business and will remain responsible for the licensed premise until a license is issued to the buyer or buyers of
the business by the Alcoholic Beverage Control.
I declare under penalties of perjury that to the best of my knowledge and belief this is a true, correct and complete
statement.
SIGNATURE ____________________________________________ *TITLE ____________________________________DATE___________________
(MANAGING OFFICER, OWNER, PARTNER, SOLE OWNER)
SIGNATURE ____________________________________________ *TITLE ____________________________________DATE___________________
(MANAGING OFFICER, OWNER, PARTNER)
SIGNATURE ____________________________________________ *TITLE ____________________________________DATE___________________
(MANAGING OFFICER, OWNER, PARTNER)
SIGNATURE ____________________________________________ *TITLE ____________________________________DATE___________________
(MANAGING OFFICER, OWNER, PARTNER)
* TITLE – state whether individual owner, member of firm, or title if officer of corporation.
ABC-811 (Rev. 7.1.12)
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