Form 385 - Application For A Brewery Special Event Permit
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1
2APPLICATION FOR A BREWERY
Form
385
SPECIAL EVENT PERMIT
Date _____________________________ , 2 ______
To the Comptroller of Maryland,
Office Use Only
Application is made by the undersigned under the provisions of Article 2B of the Annotated Code of
Number _______________
Maryland, as amended, title “Alcoholic Beverages” for the permit indicated above. This application
Permit Year _____________
shall be filed with the Office of the Comptroller not less than 15 days prior to any event.
Stub Number ___________
1. License name and/or trade name: ______________________________________________
Approved ______________
2. Mailing address: ____________________________________________________________
Date __________________
_________________________________________________________________________
Check Number __________
Business Phone No.: ________________________________________________________
Check Amount $ ________
M
License Number
___ - ___ ___ ___ ___ ___
Deposit Date____________
Federal Identification Number
___ ___ - ___ ___ ___ ___ ___ ___ ___
3. Is the event being held on the premises of the brewery? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
4. Description of Event ______________________________________________________________________________________
______________________________________________________________________________________________________
5. Do the applicants agree to conform to all laws, rules, and regulations of the State of Maryland relating to the
business in which they propose to engage under this permit? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
6. The permit for which this application is made is to be for the following day(s) ________________________________________
The applicant tenders herewith the sum of $25.00 in payment. A new application and payment must be submitted for each
special event.
7. Must be signed by a brewery licensee.
Affidavit
I/we do solemnly declare and affirm under penalties of perjury that the contents of the foregoing document are true and correct
to the best of my knowledge, information and belief.
Signature of Brewery Licensee
Type or Print Name
8. This section must be completed by the owner of the premises where the event will take place.
Statement of owner of premises required in connection with alcoholic beverages law of Maryland: I/we hereby certify that I am/
we are the owner(s) of the property known as ________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
named as the foregoing application made to the Comptroller of Maryland under the Alcoholic Beverages Law of Maryland; that I/we
assent to the granting of the permit applied for, and that I/we hereby authorize the Comptroller of Maryland, his duly authorized
deputies, inspectors and clerks, the Board of License Commissioners of the jurisdiction in which the place of business is located,
its duly authorized agents and employees, and any peace officer of such jurisdiction to inspect and search, without warrant,
the premises upon which the business is to be conducted, and any and all parts of the building in which said business is to be
conducted, at any and all hours.
COM/RAD-385
13-49
06/13
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Parent category: Financial