Application For Out-Of-State Producer Liquor Licenses- Arizona Department Of Liquor Licenses And Control Page 2
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47. If licensed in U.S., Federal ATF#: ______________________________ Your state liquor license #: _____________________________
Please attach a copy of the document that permits you to deal in liquor in your place of origin, this applies to applicants
located in the U.S. and those applying from outside of the U.S.
SECTION 5
All questions below must be answered even if the offense occurred outside of Arizona, the case has not yet been
adjudicated, you accepted a diversion program, you received a suspended sentence or probation, the charges were
dismissed or set aside, your sentence was commuted, the records were expunged, your civil rights were restored or you
received a pardon:
1. Have you EVER had an application for any business, professional or liquor license rejected?
Yes
No
2. Have you ever had disciplinary action taken against a license in another jurisdiction?
Yes
No
3. Has anyone EVER filed suit or obtained a judgment against you in any civil action, the subject of which
involved fraud or misrepresentation involving a liquor license?
Yes
No
4. Have you EVER been arrested for, charged with, or convicted of any felony?
Yes
No
5. If you answered “yes” to question 1, 2, 3, or 4, give complete details. Attach additional sheets if necessary.
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
6. Are you familiar with Arizona liquor laws and regulations as they relate to the sale and shipment of liquor into the state of
Arizona?
Yes
No
Farm wineries that produce not more than 20,000 gallons per calendar year to consumers - A.R.S. § 4-205.04(C)(9), to retailers - A.R.S. § 4-
205.04(C)(7), produce not more than 200 - 40,000 gallons to AZ licensed wholesalers - A.R.S. § 4- 205.04(C)(1), participate in an Arizona wine
festival - A.R.S. § 4-203.03 Craft distilleries that produce not more than 1,189 gallons per calendar year to consumers - A.R.S. §4- 205.10(C)(7), to
retailers - A.R.S. §4- 205.10(C)(5), to wholesalers - A.R.S. §4- 205.10(C)(1),
7. Do you agree to notify the Arizona Department of Liquor of any proposed change of ownership or other changes to the
information provided in this application within 30 days to making any such changes?
Yes
No
A.R.S. §4-203(E)
8. Do you agree to keep records, invoices, and other documents relating to your production, purchase, sale and delivery
of liquor for a period of two years and to have this documentation easily accessible for examination upon request?
Yes
No
A.A.C. R19-1-501(B)
9. Do you agree to make application for the necessary license prior to exceeding the legal sales limit for the license series
you hold?
Yes
No
2L=A.R.S. §4-209(B)(15), 2W=A.R.S. §4-205.04(C) &(C)(7), 2M=A.R.S. §4-205.08(D)(1)-(2)
10. Do you agree to pay required Arizona taxes as prescribed by law?
Yes
No
2W = A.R.S. §4-205.04(I), 2M = A.R.S. §4-205.08(F), 2D = A.R.S. §4-205.10(F)
11. For out-of-state craft distillery (series 2D) applicants only.
a) 2L & 2W = A.R.S. §4-205.04(B), 2M = A.R.S. §4-205.08(B), 2D = A.R.S. §4-205.10(B)
b) Do you agree not to sell or deliver to individuals for personal consumption except persons age 21 or older who
make purchases when physically present at your distillery?
Yes
No
A.R.S. §4-205.10(C)(3)
c) Do you agree not to sell or deliver directly to Arizona-licensed retail licensees if your production exceeds 1,189
gallons per year?
Yes
No
A.R.S. §4-205.10(C)(5)
d) Do you agree to report annual production to the Arizona Department of Liquor 30 days after your reporting period
ends (December 31)?
Yes
No
A.R.S. §4-205.10(B)
2/24/2017
Page 2 of 4
Individuals requiring ADA accommodations please call (602)542-9027
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