Kentucky > Statewide > Alcohol Beverage Control > Licensing
Schedule R Retail License - Kentucky
| Schedule R Retail License Form. This is a Kentucky form and can be used in Licensing Alcohol Beverage Control Statewide . |
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Page 1 Schedule R 01/19/10 SCHEDULE "R" RETAIL LIQUOR DRINK & PACKAGE LICENSE LEAVE BLANK FOR ABC USE ONLY Site I.D. # License # _____________ $ _________ Validating # ____________ License # _____________ $ ___________ Validating # ____________ License # _____________ $ _________ Validating # ____________ License # _____________ $ ___________ Validating # ____________ Ky. Malt Beverage Administrator's Approval ______________________________________________________ Date _________________ Ky. Distilled Spirits Administrator's Approval ______________________________________________________ Date ________________ (A.) Applicant's name(s) or company to be licensed ________________________________ D.B.A. (Name of Business) _____________________________________________________ Address of premises to be licensed ______________________________________________ (B). 1. Are you applying for a Retail Liquor by the Drink License? (KRS 243.250)................................................... If yes, are you applying for a new license available through the quota system?................................................. Is this license being transferred to you by an existing owner? ........................................................................ 1a. Are you applying for a Retailer's Liquor Drink Sampling License? ............................................................. If yes, KRS 244.050(2) requires you to hold an active Kentucky Retail Distilled Spirits & Wine by the Drink License. List your Kentucky Retail Distilled Spirits & Wine by the Drink License Number at the Sampling Location. ________ 2. Are you applying for a Retail Liquor Package License? (KRS 243.243.240)........................................................ If yes, are you applying for a new license available through the quota system?................................................. Is this license being transferred to you by an existing owner? ........................................................................ 2a. Are you applying for a Retailer's Liquor Package Sampling License? ......................................................... If yes, KRS 244.050(2) requires you to hold an active Kentucky Retail Package Liquor License. List your Kentucky Retail Package Liquor License Number at the Sampling Location. ________________________ J Yes J No J Yes J No J Yes J No J Yes J No J Yes J No J Yes J No J Yes J No J Yes J No 3. 3.a. Are you applying for a Retail Beer License?................................................................................................. Will you also sell gasoline or lubricating oil or work on motor vehicles? ............................................................ If yes, premises used for the sale of gasoline and lubricating oil or for the servicing and repair of Motor vehicles under KRS 243.280 must maintain an inventory of not less than $5,000 in food, groceries, and related J Yes J No J Yes J No products valued at cost. Do you meet this requirement? ...........................................................................J Yes J No J N/A 4. Are you applying for a Supplemental Liquor Bar License? (KRS243.037 & 241.010(49)........................................ If yes, how many additional bars do you wish to license? _______________________________________________ 5. 6. Are you applying for a Special Sunday Retail Liquor Drink License? (KRS 244.290 or KRS 244.295)................... Are you applying for a Caterer's License? (KRS 243.033) (804 KAR 4:310)............................................................. J Yes J No J Yes J No J Yes J No J Yes J No If yes, attach a copy of your food service permit issued by your local health Department? ...................................... American LegalNet, Inc. www.FormsWorkFlow.com Page 2 Schedule R 01/19/10 Site ID # (C). KRS 243.360 requires an applicant to first advertise their intention to apply for these licenses in the newspaper. Please use the attached example to assist you with this requirement. (If you are currently licensed and only adding a Sunday or a supplemental bar license to your premises you are not required to run this advertisement.) Place your advertisement once in the legal section of the newspaper having the largest circulation for the county where your premises will be located. KRS 424.120 and 424.130(1)(b) describes qualified newspapers. After your advertisement has appeared in the paper, obtain a clipping from the paper and attach the Affidavit of Publication to your ABC application. The Affidavit of Publication is enclosed and should be completed by an official of the newspaper where the advertisement appeared. (D). I do hereby solemnly swear or affirm that all statements contained in this application and all attachments are true and correct to the best of my knowledge, information and belief. I incorporate this application schedule into my ABC Basic application for a Kentucky alcoholic beverage license. I understand I may not begin to operate with alcohol activity until the Kentucky ABC Office has issued my license(s). I further swear or affirm I shall abide by all state and local statutes, regulations, and ordinances relating to the manufacture, sale, use or and trafficking in alcoholic beverages. Signature of Applicant _______________________________Title _____________Date _________ (E). OBTAIN LOCAL ABC ADMINISTRATOR'S SIGNATURE OF APPROVAL Your Local ABC Administrator must approve this application before it is forwarded to the State ABC. Take or mail this application schedule, the ABC Basic application, fees, and all attachments to your Local ABC Administrator. Obtain their signature of approval below or make arrangements for this approval to be sent to the State ABC Office. This certifies that the applicant(s) herein above named have been approved for the types of license applied for and for the premises above specified. SIGNATURE OF APPROVAL OF LOCAL ABC ADMINISTRATOR ____________________Date __________ J City of _______________________Administrator (or) the J County of _______________________Administrator You may now forward this application schedule, the ABC Basic application, all attachments, and your state license fee to: Commonwealth of Kentucky Department of Alcoholic Beverage Control 1003 Twilight Trail Frankfort, Kentucky 40601-8400 Telephone 502-564-4850 Fax 502-564-1442 http://www.abc.ky.gov American LegalNet, Inc. www.FormsWorkFlow.com Page 3 Schedule - R 01/19/10 TYP
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