Farm Winery Fair/festival License Application - Arizona Department Of Liquor Licenses And Control

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FOR 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
FARM WINERY FAIR/FESTIVAL LICENSE APPLICATION
A.R.S.§4-203.03 Farm Winery /A.R.S.§4-203.02 At Special Event
Fee: $15.00 Per Day
A service fee of $25 will be charged for all dishonored checks (A.R.S.44-6852).
When the days of the fair/festival are not consecutive, a separate license for each uninterrupted period is needed.
SECTION 1
Application type:

Wine Fair
Wine Festival
1. Applicant’s Name: _______________________________________________ Daytime Phone#: _______________________________
2. Business name: ___________________________________________________ Liquor license #: ________________________________
Farm Winery or Craft Distillery
3. Email: ____________________________________________________________________________________________________________
4. Mailing address: ___________________________________________________________________________________________________
Street Address
City
State
Zip Code
5. Location of fair/festival: ____________________________________________________________________________________________
Street address
City
County
Zip Code
This Notary to be completed only by the applicant named in section #1.
NOTARY
I,
__________________________________________________________ declare that I am the APPLICANT filing this
(Print Full Name)
application as listed in above. I have read the application and the contents and all statements are true, correct and
complete.
X ________________________________________________________________________ _______________ __________________
(Signature)
Title/ Position
Date
Phone #
State of _______________________County of _______________________
____________ of ______________________ _____________
The foregoing instrument was acknowledged before me this
Day
Month
Year
My commission expires on:
_____________________
___________________________________________________
Signature of NOTARY PUBLIC
Page 1 of 3
8/4/2017

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