Texas > Statewide > Alcoholic Beverage Commission
Application For Promotional Permit L-107 - Texas
| Application For Promotional Permit Form. This is a Texas form and can be used in Alcoholic Beverage Commission Statewide . |
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APPLICATION F O R PROMOTIONAL PERMIT TRADE NAME: TABC USE ONLY FORM L-107 (9/2011) ISSUE DATE FEE SURCHARGE LATE FEE (RENEWAL ONLY) PRFIRST READ ALL INSTRUCTIONS - TYPE OR PRINT IN INK 1. APPLICATION IS FOR: Original Renewal/Change Change of: $600 Registry No. $376 If renewal or change, enter the permit no.: PR- ALL APPLICANTS 2. APPLICANT IS: Individual Limited Partnership 3. Trade Name of Business Corporation Limited Liability Partnership Limited Liability Company Other Partnership 4. Mailing Address City State Zip Code (9 digits) Zip Code (9 digits) - Address of Location City State 5. Business Telephone Number ( ) - Alternate Telephone Number ( ) - E-Mail Address (optional) INSTRUCTIONS: If Individual Owner, complete question 7 & 8. For all others, refer to Instructions on this page. 7. Social Security Number Issuing State /Driver's License Number Date of Birth (mm/dd/yyyy) / / INDIVIDUALS Full Legal Name (Last, First, Middle) Residential Address City State Zip Code (9 digits) - 8. Has the person named in 7 above been a legal resident of Texas for one year immediately preceding the filing of this application? 8. YES NO CORPORATION(S), LLC(S) & PARTNERSHIP(S) INSTRUCTIONS FOR: CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, LIMITED PARTNERSHIP, LIMITED LIABILITY PARTNERSHIP, OTHER. For Corporations or Limited Liability Companies: Complete L-107-C for all officer(s), director(s), manager(s), stockholder(s), and member(s). If applicant is a publicly held corporation: Provide pertinent information as indicated in 4 on L-107-C on all stockholders holding 5% or more of the shares. For Partnership, Limited Partnership, or Limited Liability Partnership: Complete L-107-P ensuring you include all partners involved in business. If one or more of your general or limited partners is a limited partnership or limited liability partnership complete L-107-P for each partnership. If one or more of your General or Limited Partners is a Corporation: Complete L-107-C for each corporation or limited liability company. TABC USE ONLY INITIAL APPLICATION INCOMPLETE YES - NO PROCESS DATE: / / ADDITIONAL CORRESPONDENCE YES - NO PROCESSOR I.D.: PROCESSOR REVIEW DATE: / / PROCESSOR ERROR YES - NO Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com CORPORATION TRADE NAME: 1. FOR CORPORATION OR LIMITED LIABILITY COMPANY-OFFICER(S) AND DIRECTOR(S) OR CORPORATION, OFFICER(S) AND MANAGER(S) OF LIMITED LIABILITY COMPANY, STOCKHOLDERS/MEMBERS If applicant is a corporation or limited liability company, enter the following information: A. Federal Employer's I.D. No. B. Entity Name C. Charter No. Date Approved / / State FORM L-107-C (11/2005) D. Number and class of shares, memberships or units issued: 2. Are at least 51% of each class of shares, memberships, or units issued owned by persons who are at least 21 years of age or older? 3. Have the persons in 3 A, B and C, legally resided in Texas for at least one year immediately preceding the filing of this application? A. All officers? B. 51% of owners of each class of shares, memberships, or units issued? C. Majority of directors? 4. COMPLETE THE FOLLOWING PER INSTRUCTIONS: Social Security Number Issuing State/ Driver's License Number Full Legal Name (Last, First, Middle) Residential Address Social Security Number Issuing State/ Driver's License Number Officer Director/ Manager Date of Birth (mm/dd/yyyy) / / 2. YES NO 3A. B. C. YES NO YES NO YES NO Class & No. of Shares, Memberships or Units Held Position/Title ZIP Code (9 digits) - Stockholder/Member City Date of Birth (mm/dd/yyyy) / / State Class & No. of Shares, Memberships or Units Held Position/Title ZIP Code (9 digits) - Full Legal Name (Last, First, Middle) Residential Address Social Security Number - Officer Director/ Manager Stockholder/Member City State Issuing State/ Driver's License Number Date of Birth (mm/dd/yyyy) / / Class & No. of Shares, Memberships or Units Held Position/Title ZIP Code (9 digits) - Full Legal Name (Last, First, Middle) Residential Address Social Security Number - Officer Director/ Manager Stockholder/Member City State Issuing State/ Driver's License Number Date of Birth (mm/dd/yyyy) / / Class & No. of Shares, Memberships or Units Held Position/Title ZIP Code (9 digits) - Full Legal Name (Last, First, Middle) Residential Address Social Security Number - Officer Director/ Manager Stockholder/Member City State Issuing State/ Driver's License Number Date of Birth (mm/dd/yyyy) / / Class & No. of Shares, Memberships or Units Held Position/Title ZIP Code (9 digits) - Full Legal Name (Last, First, Middle) Residential Address Officer Director/ Manager Stockholder/Member City State (IF MORE SPACE IS NEEDED, USE ADDITIONAL COPIES OF THIS PAGE.) Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com PARTNERSHIP TRADE NAME: 1. Have all partners of the general partnership or all general partners and 51% of the total ownership of the limited partnership or limited liability partnership legally resided in Texas for at least one year FORM L-107-P (11/2005) FOR ALL PARTNERS NAMES OF PARTNER(S), LIMITED PARTNER(S) AND GENERAL PARTNER(S) immediately preceding the filing of this application? 2. All limited partnerships and limited liability partnerships must enter: A. Federal Employer's I.D. No.: B. Entity Name: C. Date Approved (mm/dd/yyyy): / / State: 1. YES NO 3. COMPLETE THE FOLLOWING PER INSTRUCTIONS: Social Security Number Issuing State/ Driver's License Number Date of Birth (mm/dd/yyyy) // % of Interest Full Legal Name of Partner (Last, First, Middle) General Partner Limited Partner Residential Address City State ZIP Code (9 Digits) - Social Security Number - Issuing State/ Driver's License Number Date of Birth (mm/dd/yyyy) // % of Interest Full Legal Name of Partner (Last, First, Middle) General Partner Limited Partner Residential Address City State ZIP Code (9 Digits) - Social Security Number - Issuing State/ Driver's License Number Date of Birth (mm/dd/yyyy) // % of Interest Full Legal Name of Partner (Last, First, Middle) General Partner Limited Partner Residential Address City State ZIP Code (9 Digits) - Social Security Number - Issuing State/ Driver's License Number Date of Birth (mm/dd/yyyy) // % of Interest Full Legal Name of Partner (Last, First, Middle) General Partner Limited Partner Residential Address City State ZIP Code (9 Digits) - Social Security Number - Issuing State/ Driver's License Number Date of Birth (mm/dd/yyyy) // % of Interest Full Legal Name of Par
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