Michigan > Statewide > Liquor Control Commission > General Licensing
Application For Catering Permit LC 3001 - Michigan
| Application For Catering Permit Form. This is a Michigan form and can be used in General Licensing Liquor Control Commission Statewide . |
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Print Form Michigan Department of Licensing and Regulatory Affairs MICHIGAN LIQUOR CONTROL COMMISSION (MLCC) 7150 Harris Drive, P.O. Box 30005 Lansing, Michigan 48909-7505 FOR MLCC USE ONLY Business ID #____________ License # _______________ Date Issued _____________ APPLICATION FOR CATERING PERMIT [Authorized by MCL 436.1547] GENERAL INSTRUCTIONS · · · A Catering Permit may only be issued to a Michigan licensed business that holds a public on premises license (Class C, Tavern, B-Hotel, A-Hotel, etc.), a specially designated merchant license and/or a specially designated distributor license. To be considered for a Catering Permit you must complete this application, sign the form, and attach a copy of your Food Service Establishment License or Retail Food Establishment License. Return the application with all required documents and a check payable to the State of Michigan for the $70 application fee and the $100.00 permit fee for a total of $170 to the address at the top of this form. MAKE A COPY OF THIS APPLICATION FOR YOUR FILE. The permit renews annually by May 1 of each year and the annual permit renewal fee is $100.00. The permit is effective May 1 through April 30. Permit fees are not prorated. PART 1. APPLICANT INFORMATION Limited Liability Company Corporation Partnership Individual 1. Check type of business entity: 2. Full name of licensed business entity: 3. D.B.A. : 4. Street Address: 5. City: 8. Check type of license: B-Hotel Resort A-Hotel 6. State: Class C Tavern B-Hotel Specially Designated Merchant 7. Zip Code: A-Hotel Resort Class C Resort Tavern Specially Designated Distributor Resort 9. Attach a copy of the Retail Food Service Establishment License or the Retail Food Establishment License Note: The Retail Food Service Establishment License or the Retail Food Establishment License must be in the same name as the public on-premises license, specially designated merchant or specially designated distributor license 10. Business Telephone Number: 12. Federal Employer Identification Number (FEIN): PART 2 ALL PARTNERS AND GENERAL PARTNERS OF LIMITED PARTNERSHIPS, AUTHORIZED CORPORATE OFFICERS, OR AUTHORIZED MEMBERS OR MANAGERS OF THE LIMITED LIABILITY COMPANY MUST SIGN THE APPLICATION. BY SIGNING THE APPLICATION: · I agree to abide by all provisions of the Michigan Liquor Control Code (P.A. 58 of 1998) and all the rules of the MLCC. · I certify that the beer, wine, and/or spirits delivered under the catering permit is required to be and will be served at the private or special licensed event. · I authorize the MLCC to investigate records of this business to determine license qualifications. · swear that all the answers on this application are true, that the applicant is the sole owner of the business and that submitting false or incomplete information is cause for denial of the permit and is a violation of the Michigan Liquor Control Code of 1998. SIGNATURE OF APPLICANTS TITLE HOME ADDRESS 11. Email Address: X X REMINDER TO ENCLOSE A CHECK MADE PAYABLE TO THE "STATE OF MICHIGAN" FOR THE AMOUNT OF THE APPLICATION FEE, PERMIT AND ENCLOSE ANY REQUIRED DOCUMENTS. LC-3001 04/2011 Authority: MCL 436.1547 Completion: Mandatory Penalty: No Permit LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities. American LegalNet, Inc. www.FormsWorkFlow.com
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