Form Abc-807 - Management Services Information
Download a blank fillable Form Abc-807 - Management Services Information in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Abc-807 - Management Services Information with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Kansas 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
MANAGEMENT SERVICES INFORMATION
SECTION 1 – LICENSEE INFORMATION
FEIN______________________
Licensee DBA Name
License Number
Location Street Address
City
County
Zip Code
SECTION 2 – MANAGEMENT SERVICES INFORMATION
Name of Person/Entity Providing Management/Operational Services
FEIN
Contact Person
Daytime Phone
The following information must be provided on all owners, officers, shareholders, stockholders, copartners and/or trustees of the entity
who will perform management services for the retail liquor licensee. (Attach additional pages as necessary). The percentages of
ownership must total 100%.
SECTION 3 – MANAGEMENT SERVICES OWNERSHIP INFORMATION
Last Name
First Name
Middle Name
Gender
Date of Birth
Birthplace
Other Names Used
Maiden Name
Social Security No.
Driver’s License No.
State
% Ownership
Position
Marital Status
Address
City
State
County
Zip Code
Daytime Phone
Last Name
First Name
Middle Name
Gender
Date of Birth
Birthplace
Other Names Used
Maiden Name
Social Security No.
Driver’s License No.
State
% Ownership
Position
Marital Status
Address
City
State
County
Zip Code
Daytime Phone
Last Name
First Name
Middle Name
Gender
Date of Birth
Birthplace
Other Names Used
Maiden Name
Social Security No.
Driver’s License No.
State
% Ownership
Position
Marital Status
Address
City
State
County
Zip Code
Daytime Phone
Last Name
First Name
Middle Name
Gender
Date of Birth
Birthplace
Other Names Used
Maiden Name
Social Security No.
Driver’s License No.
State
% Ownership
Position
Marital Status
Address
City
State
County
Zip Code
Daytime Phone
Last Name
First Name
Middle Name
Gender
Date of Birth
Birthplace
Other Names Used
Maiden Name
Social Security No.
Driver’s License No.
State
% Ownership
Position
Marital Status
Address
City
State
County
Zip Code
Daytime Phone
ABC-807 (7.1.11)
Page 1 of 2
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial