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Montana Winspec Form - Montana Application For Special Permit To Sell Table Wine (Licensed Domestic Winery Only)

MONTANA

WinSpec

New 06 13

Montana Application for Special Permit to Sell Table Wine

(Licensed Domestic Winery Only)

Please send your complete application and the appropriate fee to us at least three days before your

event.

Section 1 – General Information

Note: If the applicant is an individual, list the individual’s name below. If the applicant is a partnership,

limited liability partnership (LLP), corporation, or limited liability company (LLC) list the business’

name below.

Name of Applicant(s) ____________________________________ FEIN/SSN _________________

Contact Person ___________________________________________________________________

Telephone __________________________________Fax _________________________________

Location of Principal Place of Business _________________________________________________

(Street Address, City, State and Zip Code)

Name of Event ____________________________________________________________________

Location of Event __________________________________________________________________

(Street Address, City, State and Zip Code)

Date(s) for which special permit is desired ______________________________________________

Section 2 – Fees

$10 per day – Montana Domestic Winery (limit 12 per year)

Total Amount Enclosed $ ____________

Office Use Only:

Account Number ___________________

Amount Paid $ ____________ Amount Owed $ ____________

Permit Number ___________________________

Number of Permits ___________ of ____________

Liquor License Number _______________________________

NK - Montana Application for Special Permit to Sell Table Wine (Licensed Domestic Winery Only)

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Montana Winspec Form - Montana Application For Special Permit To Sell Table Wine (Licensed Domestic Winery Only)