District Of Columbia > Statewide > Alcoholic Beverage Regulation Administration
Solicitors License Renewal Form - District Of Columbia
| Solicitors License Renewal Form Form. This is a District Of Columbia form and can be used in Alcoholic Beverage Regulation Administration Statewide . |
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Government of the District of Columbia Alcoholic Beverage Regulation Administration For Official Use Only License Period: Initials: Date: SOLICITOR'S LICENSE RENEWAL FORM SOLICITOR'S INFORMATION Please indicate if any of the following have occurred since the last renewal period: 1. Please place an `X" in the applicable box below: Name Change 2. Solicitor's Application Number 4. Solicitor's Name Last 5. Home Address Number 6. Home Telephone EMPLOYER INFORMATION 8. License Number 10. Licensee's Name 12. Establishment's Address 9. License Class 11. Establishment's Telephone Street 7. Business Telephone City/State First Address Change 3. License Number Change in Employment (Submit an employment certificate letter from your current employer) Middle Zip code Number Street City/State Zip code 13. Certification: I hereby certify under perjury that the information in this application and attachments are true and correct to the best of my knowledge and belief. I will also conform to all laws and regulations related to the alcohol and beverage license for which I have applied. ____________________________ Signature Subscribed and sworn to before me on this _____ day _____, 20___. ____________________________ Notary Public My commission expires on _____________. 14. Please answer the question: In what language do you need vital documents translated, if any? 15. Since your last application, have you been convicted of a felony or misdemeanor? Yes No. If yes, please attach the disposition to the application. INSTRUCTIONS FOR FILING A RENEWAL APPLICATION FOR A SOLICITOR'S LICENSE APPLICATION Current solicitors' licenses expire at the end of June 2005. Please be advised that all solicitors can renew beginning June 1, 2005. The annual fee is $325. The two year renewal fee is $650 and the three year renewal fee is $975. Our hours are 8:30 am to 3:30 pm, but we also encourage the solicitors to come renew during the off-peak hours of 8:30 to 10:30 am to avoid long lines in the Customer Service Center. Under no circumstances will anyone be processed after 3:30 pm. Failure to renew timely could result in a late penalty of $50. Please read all questions carefully. Each question must be answered. 1. Please place an "x" to indicate if there is a name, address, or employment change. 2. Print your application number. 3. Print your license number. 4. Print your name (Last Name, First Name, Middle Initial). 5. Print your home address. 6. Print your home telephone number. 7. Print your business telephone number. 8. Print your employer's license number. 9. Print your employer's license class. 10. Print your wholesaler's name that appears on the ABC license. 11. Print the wholesaler's telephone number. 12. Print the wholesaler's address as it appears on the ABC license. 13. Certification/Affidavit: Please read, and have your signature notarized. 14. Please answer the question: In what language do you need vital documents translated, if any? 15. Please check the appropriate box to answer if you have been convicted of a felony or misdemeanor since your last application. If you answered "yes", please attach a copy of the disposition of the conviction to your renewal application form. SPECIAL NOTICE The District of Columbia will provide appropriate auxiliary services including sign language interpreters whenever necessary to effectuate communication with members of the public who are deaf, hard of hearing or who may have other disabilities affecting communication. Please contact the ADA coordinator at (202)4424423. American LegalNet, Inc. www.FormsWorkflow.com
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