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Application For Temporary Operating Permit 125 - Nebraska
| Application For Temporary Operating Permit Form. This is a Nebraska form and can be used in Liquor Control Commission Statewide . |
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APPLICATION FOR TEMPORARY OPERATING PERMIT (TOP) 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 Enclose completed application for liquor license from purchasers Enclose document showing sale of business; document may be in the form of purchase agreement/contract, management agreement or promissory note. Must include purchase date or closing date within 2-3 weeks of requesting TOP. Must show name of business being sold. Must be signed by seller. NAME OF EXISTING BUSINESS (SELLER) AND LICENSE #_____________________________________________________________________________________________ On (date) ____________________________ seller and buyer entered into a contract for sale of the business known as ______________________________________________________________________________________________. Buyer seeks to obtain a Temporary Operating Permit (TOP) to allow them to operate the business under the same terms and conditions of premise licensee; subject to approval by the Nebraska Liquor Control Commission (NLCC) for a period not to exceed 90 days. Seller hereby declares that they are current on all accounts with all Nebraska licensed wholesaler under section ยง53123.02. A seller who provides false information regarding such accounts is guilty of a Class IV misdemeanor for each offense. _______________________________________ Signature of Seller State of Nebraska County of ______________________________ The forgoing instrument was acknowledged before me this _______________________________ Date ______________________________________________ Signature of Buyer State of Nebraska County of ______________________________________ The forgoing instrument was acknowledged before me this ________________________________________ Date _____________________________________ Notary Public Signature Affix Seal Here ______________________________________________ Notary Public Signature Affix Seal Here FORM 125 REV 4/2012 American LegalNet, Inc. www.FormsWorkFlow.com
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