Application For Liquor License Type Or Print With Black Ink - Arizona Department Of Liquor Licenses And Control Page 4

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SECTION 11 Proximity to Church or School
Questions to be completed by 6, 7, 9, 10 and 12G applicants.
A.R.S.§4-207. (A) and (B) state that no retailer’s license shall be issued for any premises which are at the time the
license application is received by the director, within three hundred (300) horizontal feet of a church, within three
hundred (300) horizontal feet of a public or private school building with kindergarten programs or grades one (1)
through (12), or within three hundred (300) horizontal feet of a fenced recreational area adjacent to such school
building.
The above paragraph DOES NOT apply to:
e) Government license (A.R.S.§4-205.03) Series 05
a) Restaurants that do not sell growlers (A.R.S.§4-205.02) Series 12
f) Playing area of a golf course (A.R.S.§4-207 (B)(5))
b) Hotel/motel license (A.R.S.§4-205.01) Series 11
g) Wholesaler/Distributor Series 04
c) Microbrewery (A.R.S.§4-205.08) Series 03
h) Farm Winery Series 13
d) Craft Distillery (A.R.S.§4-205.10) Series 18
I) Producer Series 01
1. Distance to nearest School: _______________________________
Name of School: _________________________________
(If less than one (1) mile, note footage)
Address: _________________________________________
2. Distance to nearest Church: ______________________________
Name of Church: _________________________________
(If less than one (1) mile, note footage)
Address: _________________________________________
SECTION 12 Business Financials A.R.S.§4-202(F)
1. I am the:
Tenant:
a person who holds the lease of a property; a lessee.
Sub-tenant:
a person who holds a lease which was given to another person (tenant) for all or part of a property.
Owner
Purchaser
Management Company
2. If the premises is leased give lessors:
Name: _____________________________________________________________
Address: ____________________________________________________________
Street
City
State
Zip
3. What is the penalty if the lease is not fulfilled? $ ________________________ or Other: ________________________________
4. Total money borrowed for the Business, not including lease? $ ____________________________________________________
Please List Lenders/People you owe money to for business.
Last
First
Middle
Amount Owed
Mailing Address
City
State
Zip
(Attach additional sheet if necessary)
5. Has a license or a transfer license for the premises on this application been denied by the state within the past year?
Yes
No
If yes, attach explanation.
6. Does any spirituous liquor manufacturer, wholesaler, or employee have an interest in your business?
Yes
No
If yes, attach explanation.
1/11/2018
page 4 of 6
Individuals requiring ADA accommodations please call (602)542-2999

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