Montana
LOTAPP
Clear Form
Rev. 07-09
Lottery Application
General Information
1.
Quota Area Applying For: ______________________________________
(Required)
2.
Transaction: (choose one)
New City Beer
New “Floater” All-Beverages
New All-Beverages
Please Note:
Only one lottery application per person will be accepted. “Person” as defined in ARM 42.12.401 means any individual,
firm, partnership, limited liability company, corporation or association.
3.
Legal Applicant/Owning Entity _____________________________________________________________
(Please do not use “Doing Business As”)
Mailing Address _________________________________________________________________________
City, State, Zip __________________________________________________________________________
Contact Person ___________________________________ Daytime Contact Phone ___________________
If not filing as an individual, please list all individuals with 10% or more ownership interest on the statement on
the back of this form.
Floater Section
“Floater” means an all-alcoholic beverages license that may be transferred to a new location outside the quota area
for which it was originally issued. This type of license cannot be mortgaged or sold for 5 (five) years after the transfer. A
floater license which is issued as the result of a lottery will have a gaming restriction.
If applying for a “Floater” All-Alcoholic Beverages license, answer the following:
• Has the applicant applied for a “Floater” All-Alcoholic Beverages lottery within the previous 12 months?
No
(If you answered “yes” to this question, you do not qualify for entry in the lottery)
Yes
• Does the applicant have any ownership interest in an All-Alcoholic Beverages license?
No
(If you answered “yes” to this question, you do not qualify for entry in the lottery)
Yes
• The applicant has provided with this application an irrevocable letter of credit from a financial institution that
guarantees available credit in the amount of $100,000. Yes
(“Irrevocable letter of credit” means
No
a letter of credit in which the issuing bank guarantees that it will not withdraw the credit or cancel the letter. A
letter of credit may not be modified or revoked without the customer’s consent.) Include a copy of the letter of
credit with the application. If no letter of credit is attached with this lottery application, the application will be
disqualified.
Please Note: A license transferred pursuant to a lottery after July 1, 2007, to a quota area outside the quota area for
which it was originally issued, is not eligible to offer gambling under Title 23, chapter 5, part 3, 5, or 6.
A successful lottery applicant for a “floater” license is required to begin business within one year of the lottery.
*** Return to: Montana Department of Revenue, Liquor Control Division, PO Box 1712, Helena, MT 59624-1712