Hawaii > Local County > Maui > Department Of Liquor Control
Application For Special Liquor License DLC-016 - Hawaii
| Application For Special Liquor License Form. This is a Hawaii form and can be used in Department Of Liquor Control Maui Local County . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
DEPARTMENT OF LIQUOR CONTROL, COUNTY OF MAUI 2145 KAOHU STREET, ROOM 105, WAILUKU, MAUI, HAWAII APPLICATION FOR SPECIAL LIQUOR LICENSE Applicant: Trade Name: hereby makes the following application for a special license for a fundraising event as provided by the provisions of Chapter 281 of the Hawaii Revised Statutes, as amended by Act 148. 1. "SPECIAL": Class & Kind EFFECTIVE DATES & TIMES: LOCATION: 2. OFFICERS/DIRECTORS TITLE AGE PLACE OF RESIDENCE 3. Name of person who will be present at the event and be in active charge: 4. If premises to be used is a State or County facility, a permit will be required to allow the dispensing of alcoholic beverages. I hereby certify all necessary clearances from other government agencies have been obtained in reference to this application. DATE: BY: Signature Print Name and Position (FOR OFFICE USE ONLY) Date received: Application No.: Recommended by: Grant [ ] Refuse [ ] Approved for the Liquor Commission by the Director: License Fee: Page 1 of 2 f f f DLC-016 [rev. 04/10] American LegalNet, Inc. www.FormsWorkFlow.com DEPARTMENT OF LIQUOR CONTROL, COUNTY OF MAUI 2145 KAOHU STREET, ROOM 105, WAILUKU, MAUI, HAWAII APPLICATION FOR SPECIAL LIQUOR LICENSE These are the employees who will be serving liquor at the gathering in our premises: NAME AGE We have designated from our staff Mr/Ms to supervise the service and consumption of liquor for this occasion. By: Signature Print Name and Position Date: Phone Number: Page 2 of 2 f f f DLC-016 [rev. 04/10] American LegalNet, Inc. www.FormsWorkFlow.com
|
|||||||
