Application For Out-Of-State Producer Liquor Licenses- Arizona Department Of Liquor Licenses And Control
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4FOR DLLC USE ONLY
License #:
Arizona Department of Liquor Licenses and Control
800 W Washington 5th Floor
Date:
Phoenix, AZ 85007-2934
Approved by:
(602) 542-5141
Application for Out-of-State Producer Liquor Licenses
SECTION 1
Please check the box for the license you are applying for. Review descriptions of each license, before
submitting application. See page 4 of this application.
Out-Of-State Producer (Series 2)
A.R.S. §4-243.01 & §4-250.01
Out-Of-State Craft Distillery (Series 2D)
A.R.S. §4-205.10 & §4-250.01
Limited Out-Of-State Winery (Series 2L)
A.R.S. § 4-209(B)(15) & §4-250.01
Out-Of-State Farm Winery (Series 2W)
A.R.S. §4-205.04 & §4-250.01
Out-Of-State Microbrewery (Series 2M)
A.R.S. §4-205.08 & §4-250.01
Agent Change, Arizona liquor license #:
Section 2 Type of ownership:
Individual
Partnership
Corporation
LLC
Other
Ownership Name: _____________________________________________________________________________________________________
Section 3 Fees, Issuance & Renewals:
All Arizona out-of-state licenses expire on November 30. Late renewals result in penalties.
Series
Application & Issuance Fees
Renewal
Late Renewal
Agent
Returned
Processing
Applied between the months
+ surcharge
Fee
Change
Check Fee
Timeframe
2
Dec – May
June – November
$120
$270
$100
$25
10 days
$350
$325
2D
Dec – May
June – November
$370
$520
$100
$25
10 days
$700
$550
2L
Dec – May
June – November
$95
$245
$100
$25
10 days
$150
$137.50
2M
Dec – May
June – November
$370
$520
$100
$25
10 days
$700
$550
2W
Dec – May
June – November
$170
$320
$100
$25
10 days
$300
$250
SECTION 4
Applicant:
1. Individual Owner/Agent name: ______________________________________________________________________________________
Last
First
Middle
2. Business Location name: _____________________________________________________________________________________________
Exactly as it appears on your State License/Permit
3. Business address: ____________________________________________________________________________________________________
Exactly as it appears on your State License/Permit (do not use P.O. Box number)
4. Mailing address: _____________________________________________________________________________________________________
All correspondence will be mailed to this address
5. Business phone: ______________________________________ Daytime Contact phone: ______________________________________
6. Permanent email address: __________________________________________________________________________________________
2/24/2017
Page 1 of 4
Individuals requiring ADA accommodations please call (602)542-9027
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