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Application For State Of Illinois Brokers Liquor License IL 567-0060 - Illinois
| Application For State Of Illinois Brokers Liquor License Form. This is a Illinois form and can be used in Liquor Control Commission Statewide . |
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Illinois Liquor Control Commission Rod R. Blagojevich Governor 100 W. RANDOLPH ST. SUITE 7-801 CHICAGO, ILLINOIS 60601 TELEPHONE: 312-814-2206 FAX: 312-814-2241 TDD: 312-814-1844 101 W. JEFFERSON ST. SUITE 3-525 SPRINGFIELD, ILLINOIS 62702 TELEPHONE: 217-782-2136 FAX: 217-524-1911 WEB SITE: www.state.il.us/LCC APPLICATION FOR STATE OF ILLINOIS BROKER'S LIQUOR LICENSE DEFINITIONS: "Broker" means (i) a person who solicits orders for or offers to sell or supply alcoholic liquors to retailers for a fee or commission, for or on behalf of a person authorized to manufacture or sell at wholesale alcoholic liquors within or without the State or (ii) a person within this State, other than a retail licensee, who, for a fee or commission, promotes, solicits, or accepts orders for alcoholic liquor, for use or consumption and not for resale, to be shipped from this State and delivered to residents outside of this State by an express company, common carrier, or contract carrier. This section does not apply to any person who promotes, solicits, or accepts orders for wine as specifically authorized in Section 6-29 of this Act. BROKER'S LIQUOR LICENSE FEE $600.00 Make check or money order payable to the Illinois Liquor Control Commission. The Commission does not accept U.S. currency/cash as payment. Please print or type the information requested in the spaces provided. The application form must bear an original signature. IMPORTANT NOTICE: THE ILLINOIS LIQUOR CONTROL COMMISSION IS REQUESTING DISCLOSURE OF INFORMATION THAT IS NECESSARY UNDER THE ILLINOIS LIQUOR CONTROL ACT (235 ILCS 5/1 ET SEQ.). DISCLOSURE OF THIS INFORMATION IS MANDATORY. FAILURE TO PROVIDE ANY INFORMATION WILL RESULT IN THE NON-ISSUANCE OF YOUR LICENSE. FORM APPROVED BY THE STATE FORMS MANAGEMENT CENTER. IL 567-0060 (03/2006) Printed on Recycled Paper PAGE 1 OF 6 American LegalNet, Inc. www.FormsWorkflow.com General Information - Broker a. Brokers CANNOT for a fee or commission promote, solicit, or accept orders for alcoholic liquor at retail, for use and consumption and not for resale, to Illinois residents. b. Brokers CAN for a fee or consumption promote, solicit, or accept, orders for alcoholic liquor at retail, for use and consumption and not for resale, to residents of other states outside of Illinois, pursuant to the laws of those states. c. Brokers, located within or outside of Illinois, CAN for a fee or commission promote, so licit, or accept orders for alcoholic liquor, from licensed Illinois retailers. NOTE: All alcoholic liquors sold to licensed Illinois retailers must be shipped by licensed Illinois distributors, importing distributors, or foreign importers. d. Brokers, located within or outside of Illinois, CAN on behalf of a licensed Illinois retailer make contact with distillers, rectifiers, brewers or manufacturers or any other party within or outside of Illinois in order that alcoholic liquors be shipped to a licensed Illinois distributor, importing distributor or foreign importer, whether such solicitation or offer is consummated within or outside of Illinois. Who Does Not Need to be Licensed as a Broker? Persons who promote, solicit or accept orders for wine products on behalf of a lawfully licensed entity as part of a reciprocal wine shipment to residents over the age of 21 for personal use and not for resale as long as it is not more than 18 liters of wine. What Will Happen to Persons Making Prohibited Sales of Alcoholic Liquor? Any person discovered making unlawful sales of alcoholic liquors is in violation of the Illinois Liquor Control Act of 1934 and shall receive a "Cease and Desist Order" from the Illinois Liquor Control Commission. Furthermore, such person will also be subject to appropriate action by the Illinois Department of Revenue and the States' Attorney in the county in which the alcoholic liquor product was delivered. IL 567-0060 (03/2006) PAGE 2 OF 6 American LegalNet, Inc. www.FormsWorkflow.com FOR OFFICE USE ONLY LICENSE NO. DATE ISSUED EXPIRATION DATE COUNTER ! Application for State of Illinois Broker's Liquor License 1. APPLICANT - CORPORATE INFORMATION A. FEIN Enter your Federal Employer Identification Number (FEIN) in this box. The FEIN is a nine-digit number issued by the U.S. Internal Revenue Service. This number is used for verification purposes only. If you do not have an FEIN number, call 1-800-829-3676 for general information on how to apply and to obtain the forms you will need. NOTE: if you have filed an application for your FEIN number, the Commission will accept your application. FEIN # B. ILLINOIS BUSINESS TAX NUMBER (IBT OR SALES TAX NO.) IF APPLICABLE Enter the eight-digit Illinois Department of Revenue Business Tax (Sales Tax) Number. You must have this number in order for a license to be issued. If you need to obtain this number, call the Illinois Department of Revenue in Chicago at (312) 814-5258 or in Springfield at (217) 785-2889. ILLINOIS BUSINESS TAX # C. TELEPHONE Enter the area code/telephone number/extension of the corporation, partnership, etc. AREA CODE/TELEPHONE NO. ( D. ) EXT. COUNTY Enter the county where the corporation, partnership, etc. is located. COUNTY E. CORPORATE NAME (Also list DBA name if different from corporate name) Enter the name of the sole proprietorship (assumed name), partnership, corporation (Illinois, national, or foreign), or limited liability company in this box. Note: this name must be consistent with the name printed on your Illinois Department of Revenue Sales Tax Registration Certificate. CORPORATE NAME DBA NAME F . ADDRESS Enter the street address, city, state, and Zip Code of the corporation, etc.. ADDRESS CITY STATE ZIP CODE IL 567-0060 (03/2006) PAGE 3 OF 6 American LegalNet, Inc. www.FormsWorkflow.com 2. STATUS OF BUSINESS Check the applicable box (assumed name/sole proprietorship, partnership, Illinois corporation, foreign corporation, limited liability company) which corresponds to your business' official papers filed with the Office of the Secretary of State. Based on the box that you check, provide the date of the filing of the sole proprietorship/assumed name with the county clerk; in the case of a copartnership, the date of formation of the partnership; in the case of an Illinois corporation, the date of its incorporation; in the case of a foreign corporation, the foreign state where it was incorporated and the date, as well as the date of its becoming qualified under the "Business Corporation Act of 1983" to transact
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