New Hampshire > Statewide > Liquor Commission

Request For Application For License (Liquor And Table Wine Vendor) - New Hampshire

Request For Application For License (Liquor And Table Wine Vendor) Form. This is a New Hampshire form and can be used in Liquor Commission Statewide .
 Fillable pdf Last Modified 3/26/2007
Get this form for FREE as a print-only pdf

STATE LIQUOR COMMISSION STATE OF NEW HAMPSHIRE PO BOX 1795 CONCORD, NH 03302-1795 271-3521 REQUEST FOR APPLICATION FOR LICENSE CONTROL NO.__________________ DISTRICT (LIC SPEC)__________ TERRITORY # ____________ LICENSE TYPE(beer,wine,liq,lounge)________ SPI DATE_________________ TYPE OF APPLICATION _____Liquor &Table Wine Vendor__________________________ NON REFUNDABLE PROCESSING FEE TO BE MAILED WITH THIS REQUEST: $100 FOR REQUEST FOR APPLICATION CORP/LLC NAME _________________________________________________ __________________________ DATE OF INCORP/LLC. M/D/Y APPLICANT NAME ________________________________________________ __________________ LAST FIRST DATE OF BIRTH HOME ADDRESS ________________ ________________________________________________________________ NO. STREET _______________________________ CITY TRADE NAME ______________________________________________ STATE & ZIP ___________________________________________________________________________________ _____________________________________________________________ STREET LOCATION FOR LICENSE _____________ NO. ______________________________ ______________ _______________________________________ CITY COUNTY STATE & ZIP MAILING ADDRESS ___________________________________________________________________________________ NO. & STREET _____________________________________ CITY ________________________________________ STATE & ZIP IS THIS A SINGLE PROP?____________PARTNERSHIP?_____________CORPORATION?____________LLC?__________ IF CORP., WHAT STATE CHARTERED IN? _________________________________________________________________ APPLICANT: 1. OWNS _______________ 2. LEASES __________________ 3. RENTS ____________________ PREMISES. HAS APPLICANT PREVIOUSLY OWNED/HAD INTEREST IN ANY LIQUOR LICENSE_________WHEN______________ IF YES :GIVE LICENSE NO. ______________ AND NAME___________________________________________________ PHONE NUMBER YOU MAY BE REACHED AT ____________________________________ E-MAIL ADDRESS: ____________________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com MUST BE COMPLETED IN FULL AND RETURNED WITH REQUEST FOR APPLICATION ___________________________________________________________ ________________________________________________ Name: Mr./Mrs. Title(Pres,Mbr etc..) _________________________________________________________ __________________________ ______________________ Address: State Zip ____________________________ Home Phone ____________________________________ M F ________ ___________ ____________ Social Security #/Alien Reg. # Sex Race DOB POB __________________________________________ ____________ _____________ ______________ ___________________ Drivers Lic # Hgt. Wght. Eye Hair ______________________________________________________________ ___________________________________________ Mothers Name Maiden name: _______________________________________________________________ ___________________________________________ Fathers Name ___________________________________________________________ ________________________________________________ Name: Mr./Mrs. Title(Pres,Mbr,etc..) _________________________________________________________ __________________________ ______________________ Address: State Zip ____________________________ Home Phone ____________________________________ M F ________ ___________ ____________ Social Security #/Alien Reg. # Sex Race DOB POB __________________________________________ ____________ _____________ ______________ ___________________ Drivers Lic # Hgt. Wght. Eye Hair ______________________________________________________________ ___________________________________________ Mothers Name Maiden name: _______________________________________________________________ ___________________________________________ Fathers Name ___________________________________________________________ ________________________________________________ Name: Mr./Mrs. Title(Pres,Mbr,etc..) _________________________________________________________ __________________________ ______________________ Address: State Zip ____________________________ Home Phone ____________________________________ M F ________ ___________ ____________ Social Security #/Alien Reg. # Sex Race DOB POB __________________________________________ ____________ _____________ ______________ ___________________ Drivers Lic # Hgt. Wght. Eye Hair ______________________________________________________________ ___________________________________________ Mothers Name Maiden name: _______________________________________________________________ ___________________________________________ Fathers Name American LegalNet, Inc. www.FormsWorkflow.com
Link/Embed this Document
URL
Embed


Popular Searches

  1. abstract of judgment
  2. Affidavit of Indigency
  3. VERIFICATION
  4. petition for summary administration
  5. order of protection
  6. Case Management Statement
  7. default
  8. Civil Case Cover Sheet
  9. QUIT CLAIM DEED
  10. lien

Bookmark and Share