New Jersey > Statewide > Division Of Alcoholic Beverage Control
Retail Liquor License Application - New Jersey
| Retail Liquor License Application Form. This is a New Jersey form and can be used in Division Of Alcoholic Beverage Control Statewide . |
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Division of ALCOHOLIC BEVERAGE CONTROL 140 East Front Street, P.O. Box 087, Trenton, New Jersey 08625-0087 APPLICATION FOR RETAIL ALCOHOLIC BEVERAGE LICENSE Applicants should complete the application in full. Where a question is not applicable, please enter the letters "N/A." Where additional pages are necessary, you may photocopy any part of this application. A complete application is required whenever any of the following is requested: New License; Person-to-Person Transfer; Place-to-Place Transfer (including expansion of premises); Partnership changes (except Limited Partnerships); Change of Corporate Structure (of more than 33 1/3% interest); Extension to Administrator, Executor, Receiver, Trustee in Bankruptcy; License Renewal (unless an alternate application is provided by the Division of ABC) OR When required by the Division or the Local Issuing Authority. If you are reporting a change in facts about your license which does not involve one of the above transactions, complete Page 1 and any page[s] of the application on which information to be changed appears. You must also complete a Certification Page (Page 11). The original and two copies of the completed application, or pages reporting changes, should be submitted to the MUNICIPAL CLERK or BOARD OF ALCOHOLIC BEVERAGE CONTROL SECRETARY of the Municipality which will act on the request. It is the responsibility of the applicant to provide the required copies of the license application. One copy of the application should be returned to the applicant by the Municipality. It should be maintained with other records and available for inspection on the licensed premises. All fees are to accompany the application at the time of filing with the local issuing authority. A $200.00 filing fee, in the form of a CERTIFIED CHECK or MONEY ORDER payable to the Division of Alcoholic Beverage Control should accompany all applications for New Licenses, License Transfers or License Renewals. Local licensing fees are established by the Local Issuing Authority; consult the Municipal Clerk or ABC Board Secretary for information in this regard. L PS New Jersey Department of Law & Public Safety American LegalNet, Inc. www.FormsWorkFlow.com TR#: FEE: _____________________ _____________________ STATE OF NEW JERSEY DEPARTMENT OF LAW AND PUBLIC SAFETY DIVISION OF ALCOHOLIC BEVERAGE CONTROL RETAIL LIQUOR LICENSE APPLICATION DATE APPLICATION FILED: _____ / _____ / _____ [ Action ID Code [][][] A W D U ] DATE: _____________________ STATE ASSIGNED LICENSE NUMBER ______ - ______ - ______ - ______ [For DIVISION use only _________ ] CODE TYPE OF LICENSE (CHECK ONE) THIS APPLICATION IS FOR: CLASS C LICENSES [R.S. 33:1-12] 31 32 33 36 37 35 34 44 43 OTHER 14 40 _____ Annual State Permit (R.S. 33:1-42, NJAC 13:2-52) _____ Special Permit for a Golf Facility (NJAC 13:2-5.3) _____ Club _____ Plenary Retail Consumption w/Broad Package Privilege _____ Plenary Retail Consumption _____ Plenary Retail Consumption (Hotel/Motel Exception) _____ Plenary Retail Consumption (Theatre Exception) _____ Seasonal Retail Consumption (November 15 through April 30) _____ Seasonal Retail Consumption (May 1 through November 14) _____ Plenary Retail Distribution _____ Limited Retail Distribution _____ A New License Person-to-Person Transfer (Including Partnership change, except Limited Partnership) _____ Place-to-Place Transfer (Including expansion of premises) _____ Change of Corporate Structure _____ Extension of License (to Executor, Receiver, Administrator, etc.) _____ Renewal of License _____ Amendment of Application on File _____ Other ___________________________ ______________________________________ ____________________________________________________________________________________________________________ This Area is Reserved for Municipal Use Municipal Fee $_________________ Effective Date _______ / _______ / _______ (As Stated in Resolution. Date of resolution unless otherwise established.) State Fee $_________________ Date Denied _______ / _______ / _______ (As Stated in Resolution) Refund Amount $________________ Special Conditions Attached: _______ Yes _______ No ____________________________________________________________________________________________________________ Type or Print Name (Last Name, First Name, Middle Initial) of Municipal Clerk or ABC Secretary ____________________________________________________________________________________________________________ Signature of Municipal Clerk or ABC Secretary American LegalNet, Inc. www.FormsWorkFlow.com Page 2 PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER _______ - _______ - _______ - _______ Application is made on behalf of: 1 = An Individual 3 = A Partnership 5 = Incorporated Club ________ 2 = Business Corporation 4 = Unincorporated Club 6 = Limited Partnership 7 = Limited Liability Company 2.1 NAME(S) AS IT DOES OR WILL APPEAR ON THE LICENSE CERTIFICATE (NOT "TRADE" NAME): License may be held by Individual (Last Name, First Name, Middle Initial), Partnership or Corporation. ____________________________________________________________________________________________________ (Last Name, First Name, Middle Initial or Corporate Name) 2.2 ACTUAL ADDRESS WHERE THE LICENSE IS TO BE USED (SITED PREMISES): Street Address _______________________________________________________________________________________ Number Street Name Municipality ________________________________________________________________ Telephone number of business ( _______ ) _______________ - _______________ Area Exchange Number Zip __________ - _________ 2.3 If no licensed premises exists or if a mailing address is different than the "actual address" given above, provide the mailing addres (insert N/A if not applicable): Street Address _______________________________________________________________________________________ Number Street Name P.O. Box # __________ Zip __________ - __________ Municipality _______________________________________ State ________________ Telephone ( _____ ) _______ - _______ 2.4 2.5 New Jersey Sales Tax Certificate of Authority No. ____________________________________________________________ TRADE NAME(S) UNDER WHICH BUSINESS IS TO BE CONDUCTED. ALL TRADE NAMES MUST BE LISTED AND REGISTERED WITH THE N.J. SECRETARY OF STATE [if a corporation] OR COUNTY CLERK [if a partnership or sole proprietor]: ____________________________________________________________________________________________________
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