Connecticut > Statewide > Department Of Consumer Protection > Liquor Control Division
Application For Brand Label Registration - Connecticut
| Application For Brand Label Registration Form. This is a Connecticut form and can be used in Liquor Control Division Department Of Consumer Protection Statewide . |
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For Official Use Only LBD-01 Rev 9/09 STATE OF CONNECTICUT Department of Consumer Protection Liquor Control Division 165 Capitol Avenue Hartford, CT 06106 Telephone: (860) 713-6200 Web Site: www.ct.gov/dcp APPLICATION FOR BRAND LABEL REGISTRATION INSTRUCTIONS: Please print clearly or type. Complete application and submit to the address above for each brand label to be registered. This application must be accompanied by a check and/or money order made payable to "Treasurer, State of CT." See fee schedule below. Type or print legibly the Company Name and Address Company Name Address Fee Schedule: (fee applies for a 3-year period) 1). Registrant located in Connecticut: $200.00 per label 2). Registrant located Out-of-State: $200.00 per label 3). Manufacturer located in Connecticut: $15.00 per label If the Company Name on the label differs from that of the Registrant, check ( ) the appropriate box for each brand label to be registered. Authorized Agent Attach Authorization Item No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 BRAND NAME (as it appears on the label) Unimerc Brand Code DBA or Trade Name American LegalNet, Inc. www.FormsWorkFlow.com
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