Maine > Statewide > Liquor Licensing And Inspection Division
Application For License For Incorporated Civic Organization - Maine
| Application For License For Incorporated Civic Organization Form. This is a Maine form and can be used in Liquor Licensing And Inspection Division Statewide . |
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MAINE DEPT OF PUBLIC SAFETY STATE OF MAINE Liquor Licensing & Inspection Division 164 State House Station Augusta ME 04333-0164 Tel: (207) 624-7220 Fax: (207) 287-3424 APPLICATION FOR LICENSE FOR INCORPORATED CIVIC ORGANIZATION $50.00 Fee / $10.00 Filing Fee Check Payable: Treasurer State of Maine 1. (a) Full Name of Applicant: _______________________________________________________________ (Corporate Name) (b) Corporate Address: ___________________________________________________________________ Street Address City/Town State Zip Code (c) Authorized Corporate Office: ___________________________________________________________ (d) Address: ____________________________________________________________________________ Street Address Town/City State Zip Code (c) Telephone Number: ____________________________ Fax: ______________________ INFORMATION PERTAINING TO SPECIAL EVENTS OR GATHERINGS 2. (a) Title and Purpose of Event: _____________________________________________________________ ____________________________________________________________________________________ (b) Date of Event: ____________________ (c) Inside Time From: _________AM/PM To: _________AM/PM Outside Event (If Outside, attach diagram of area) (d) Location of Event: ____________________________________________________________________ (e) Number of Persons Attending: __________________________________________________________ (f) Name and Address of Sponsor: __________________________________________________________ Address: _________________________ Town/City: ___________________ State: ______________ (g) Name and Address of Caterer: __________________________________________________________ Address: _________________________ Town/City: ___________________ State: ______________ (If other than licensee): ________________________________________________________________ (If food is to be served): _______________________________________________________________ (h) Type of building to be occupied: _________________________________________________________ IncorpCivicOrg /2003 American LegalNet, Inc. www.FormsWorkflow.com (i) Area to be licensed: ___________________________________________________________________ Dated at: _______________________________________ Town/City, State on _____________________, 20_________ Month/Day NOTE: This application must be signed by a duly authorized officer of the corporation executing the application and approved by the Municipal Officer/Country Commissioners and filed with the Liquor Licensing & Inspection Division. _______________________________________ NAME OF CORPORATION BY: _________________________________________ CORPORATE OFFICER'S SIGNATURE TITLE ____________________________________ PRINTED NAME & TITLE STATE OF MAINE Dated at: _____________________________________, Maine _______________________________ ss City/Town (County) On: _________________________________________ Date The undersigned being: City Town Municipal Offices County Commissioners of the Plantation Unincorporated Place of: ______________________, Maine Hereby certify that we have given public notice on this application and held public hearing thereon as required by Section 653 Title 28A, Maine Revised Statutes and herby approve said application. Signature Print 72 Hours in Advance of Said Event or Gathering REQUESTED N.B. If said event or gathering is located in an unincorporated place, the application must be approved by the County Commissioners of the County wherein the event or gathering is to take place and the above approval form may be changed in accordance with the fact. IncorpCivicOrg /2003 American LegalNet, Inc. www.FormsWorkflow.com
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