Application For Special Event License - Arizona Department Of Liquor Licenses And Control Page 3
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5SECTION 7
How is this special event going to conduct all dispensing, serving, and selling of spirituous liquors? Please read R-19-
318 for explanation and check one of the following boxes.
Place license in non-use
Dispense and serve all spirituous liquors under retailer’s license
Dispense and serve all spirituous liquors under special event
Split premise between special event and retail location
(IF USING RETAIL LICENSE, PLEASE SUBMIT A LETTER OF AGREEMENT FROM THE AGENT/OWNER OF THE LICENSED PREMISES TO SUSPEND OR
SPECIAL
RUN CONCURRENT WITH THE PERMANENT LICENSE DURING THE EVENT. IF THE
EVENT IS ONLY USING A PORTION OF THE PREMISES,
AGENT/OWNER WILL NEED TO SUSPEND THAT PORTION OF THE PREMISES.)
SECTION 8
What is the purpose of this event?
On-site consumption
Off-site (auction/wine/distilled spirits pull)
Both
SECTION 9
1. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
Yes
No (
If yes, attach explanation.)
2. How many special event days have been issued to this organization during the calendar year? ________________________
(The number cannot exceed 10 days per year.)
3. Is the organization using the services of a licensed contractor or other person to manage the sale or service of alcohol?
Yes
No
(If yes, must be a licensed contractor or licensee of series 6, 7, 11, or 12)
4. List all people and organizations who will receive the proceeds. Account for 100% of the proceeds. The organization
applying must receive 25% of the gross revenues of the special event liquor sales. Attach an additional page if necessary.
Name _______________________________________________________________ Percentage: __________________________________
Address _____________________________________________________________________________________________________________
Name ________________________________________________________________ Percentage: _________________________________
Address _____________________________________________________________________________________________________________
Street
City
State
Zip
Please read A.R.S. § 4-203.02 Special event license; rules and R19-1-205 Requirements for a Special Event License.
Note: ALL ALCOHOLIC BEVERAGE SALES MUST BE FOR CONSUMPTION AT THE EVENT SITE ONLY.
NO ALCOHOLIC BEVERAGES SHALL LEAVE A SPECIAL EVENT UNLESS THEY ARE IN AUCTION WINE OR DISTILLED SPIRITS PULL
SEALED CONTAINERS OR THE SPECIAL EVENT LICENSE IS STACKED WITH WINE /CRAFT DISTILLERY FESTIVAL LICENSE.
5. What type of security and control measures will you take to prevent violations of liquor laws at this event?
(List type and number of police/security personnel and type of fencing or control barriers, if applicable.)
_________________Number of Police _________________ Number of Security Personnel
Fencing
Barriers
Explanation:
9/12/2017
Page 3 of 5
Individuals requiring ADA accommodations call (602)542-2999
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