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New Brand Registration Application - New Jersey
| New Brand Registration Application Form. This is a New Jersey form and can be used in Division Of Alcoholic Beverage Control Statewide . |
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STATE OF NEW JERSEY DEPARTMENT OF LAW AND PUBLIC SAFETY DIVISION OF ALCOHOLIC BEVERAGE CONTROL P.O. BOX 087 TRENTON, NEW JERSEY 08625-0087 NEW BRAND REGISTRATION APPLICATION (N.J.S.A. 33:1-2; N.J.A.C. 13:2-33) ALL INFORMATION MUST BE PRINTED OR TYPED FILING FEE: $23 PER PRODUCT PLEASE MAKE THE CHECK PAYABLE TO THE DIVISION OF ABC ) or AUTHORIZED AGENT ( ) FILING STATUS: BRAND OWNER ( NAME: ADDRESS: CONTACT PERSON: CHECK ONE CLASSIFICATION: BRAND (PRODUCT) REGISTRANT: N.J. LICENSE NUMBER (IF ANY) PHONE NUMBER: WINE ( ) BEER* ( ) DISTILLED SPIRITS ( ) HAVE THE PRODUCTS LISTED BELOW RECEIVED LABEL APPROVAL FROM THE FEDERAL ALCOHOL AND TOBACCO TAX AND TRADE BUREAU? YES ( ) NO ( ) IF AUTHORIZED AGENT, DOES REGISTRANT HAVE LETTER OF AUTHORIZATION FROM THE BRAND OWNER? YES ( ) NO ( ) PRODUCT [LABEL] NAME & VINTAGE IF APPLICABLE 1. _____________________________________________________ LIST ALL VINTAGES: ______, ______, ______, ______,______ 2. _____________________________________________________ LIST ALL VINTAGES: ______, ______, ______, ______,______ 3. _____________________________________________________ LIST ALL VINTAGES: ______, ______, ______, ______, ______ 4. _____________________________________________________ LIST ALL VINTAGES: ______, ______, ______, ______, ______ 5. _____________________________________________________ LIST ALL VINTAGES: ______, ______, ______, ______, ______ 6. _____________________________________________________ LIST ALL VINTAGES: ______, ______, ______, ______, ______ 7. _____________________________________________________ LIST ALL VINTAGES: ______, ______, ______, ______, ______ 8. _____________________________________________________ LIST ALL VINTAGES: ______, ______, ______, ______, ______ *SEE INSTRUCTIONS IF DEPOSIT INFORMATION APPEARS ON LABEL American LegalNet, Inc. www.FormsWorkFlow.com (OFFICE USE ONLY) REGISTRATION NUMBER _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ DESIGNATED NEW JERSEY WHOLESALE DISTRIBUTORS (INCLUDE SELF IF APPLICABLE) LICENSE NUMBER: LICENSEE NAME: THE UNDERSIGNED HEREBY CERTIFIES THAT THE LABELS FOR THE PRODUCTS LISTED HAVE BEEN REGISTERED WITH AND APPROVED BY THE FEDERAL ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, THAT HE IS THE BRAND OWNER OF LABEL(S) OR HE IS DULY AUTHORIZED TO EXECUTE THIS APPLICATION AND WILL PRODUCE WITHIN FORTY-EIGHT HOURS UPON DEMAND ANY FEDERAL LABEL APPROVAL AND/OR AUTHORIZATION. TYPE OR PRINT AUTHORIZED SIGNATOR DATE SIGNATURE IF YOU HAVE ANY QUESTIONS, PLEASE CALL (609) 984-2371. REVISED 10/28/10 American LegalNet, Inc. www.FormsWorkFlow.com
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