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Application For Change Of Location To Liquor License 111 - Nebraska
| Application For Change Of Location To Liquor License Form. This is a Nebraska form and can be used in Liquor Control Commission Statewide . |
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APPLICATION FOR CHANGE OF LOCATION TO LIQUOR LICENSE NEBRASKA LIQUOR CONTROL COMMISSION 301 CENTENNIAL MALL SOUTH PO BOX 95046 LINCOLN, NE 68509-5046 PHONE: (402) 471-2571 FAX: (402) 471-2814 Website: www.lcc.ne.gov Office Use Application needs to include the following: x Must include processing fee of $45.00 made payable to Nebraska Liquor Control Commission x Must include a copy of the lease, deed or purchase agreement showing ownership of new location o Document must show ownership in name of licensee, if licensed as corporation or LLC must show that name x Must include simple sketch showing new building, must include outside dimensions in feet (not square feet), direction north, if it's a one or two story building, if there is a basement. No blue prints. x May include a letter of explanation LIQUOR LICENSE #_____________________________________ LICENSEE NAME__________________________________________________________________________ TRADE NAME_____________________________________________________________________________ CURRENTLY LICENSED ADDRESS__________________________________________________________ CITY______________________________________________________________________________________ CONTACT PERSON______________________________________________________ CONTACT PERSON PHONE NUMBER _____________________________________ Change of location application will not be accepted if moving to a different jurisdiction (i.e. city or county), a new application will need to be filed. Complete the following questions: 1. What is the new address? ____________________________________________________________________ 2. City ________________________________________ County ______________________________________ 3. When do you expect on moving to new location? _________________________________________________ 1 American LegalNet, Inc. www.FormsWorkFlow.com ______________________________________________________________ Print Name of Signature _____________________________________________________________ Signature of Licensee or Officer State of Nebraska County of_____________________________________________________ The forgoing instrument was acknowledge before me this ____________________________________ Date ______________________________________________________________ Notary Public Signature Affix Seal Here 2 American LegalNet, Inc. www.FormsWorkFlow.com
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