Permit Renewal Application Form
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4PERMIT-RENEWAL
prmtrenapp.rev-1/17/13
The Renewal Notice previously mailed to you must be
submitted with this Renewal Application
PLEASE ALLOW TEN(10) BUSINESS DAYS FOR PROCESSING. BE ADVISED THAT ANY DEFICIENCY IN
THE APPLICATION OR FAILURE TO PROVIDE ALL SUPPORTING DOCUMENTATION WILL DELAY THE
PROCESSING OF YOUR RENEWAL OR MAY LEAD TO THE DISAPPROVAL OF YOUR RENEWAL.
Documents to include with your renewal application:
1. Completed Renewal Application form and Renewal Notice;
2. Personal, business, bank check or money order in the total amount due as listed on the invitation to renew.
Write your license serial number on the check. Submit a check or money order with the Renewal Application.
Make check or money order payable to New York State Liquor Authority;
3. Original surety bond in the appropriate amount; signed by the licensee; and with the expiration of the bond being the
same as the license expiration date on the Renewal Notice previously mailed to you. The bond must have the premises
name and address typed exactly as it appears on your license certificate;
4. Notice of appearance if an attorney or representative assisted in completing this renewal application.
If there have been any changes to the principals of the license, any physical changes to the
establishment or changes to the approved method of operation you must file the appropriate
change application that can be found on our website at: You must
receive approval from the Authority before making any such changes.
The completed application and any supporting information, including the Renewal Notice,
should be mailed to our bank lockbox address of:
M&T Bank Lockbox
New York State Liquor Authority
PO Box 8000-Dept 930
Buffalo, New York 14267
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