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Application For License For Importer And Wholesale Dealer Of Wine, Liquor And Beer LTD 6 - Nevada

Application For License For Importer And Wholesale Dealer Of Wine, Liquor And Beer Form. This is a Nevada form and can be used in Liquor Tax Department Of Taxation Statewide .
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Original To Board of County Commissioners Copy to Nevada Department of Taxation, Carson City Form LTD 6 03-13 APPLICATION FOR LICENSE FOR IMPORTER AND WHOLESALE DEALER OF WINE, LIQUOR AND BEER , 20 Honorable Board of County Commissioners: County, (City or Town) Nevada In accordance with the provisions of NRS, Chapter 369, as amended, the undersigned hereby applies for a license for (Type of license(s) ­ see reverse side) In the State of Nevada, for the fiscal year ending June 30, 20 of , 20 to the 30th day of June, 20 a remittance covering the license fees from the 1st day is enclosed (not less than one quarter of a year). The following information is also set forth: (1) Name of firm (2) Doing business as Located at (Physical Address) Mailing address (3) The applicant is: (a) A corporation? Yes No Organized under the laws of what state? No When? 20 When? Phone ( ) - 20 Qualified to do business in Nevada? Yes Names and addresses of following officers: President: Vice President: Secretary: Treasurer: Manager(s) Resident Agent: (b) A partnership? Yes Where? Names and addresses and official position, if any, of partners No Is agreement recorded? Yes No (c) Operating under a fictitious firm name? Yes Where? No Is statement recorded? Yes No Names, addresses and official positions, if any, of all persons interested in the business: (d) An individual? Yes No (e) Has any individual who is interested, financially or otherwise, in the applicant's business, ever been convicted of a violation of Federal or any state liquor laws? Yes No OVER American LegalNet, Inc. www.FormsWorkFlow.com If so, furnish: Name Address Where convicted When 20 20 20 (f) Is any person listed on this import/wholesale application engaged in the business of manufacturing, blending or bottling of alcoholic beverages or retailing of alcoholic beverages? (see attached copy of NRS 597.210) Yes If so, what percent, name and location of business % No (g) Are all persons listed on this import/wholesale application aware of transactions between wholesalers, retail liquor stores; limitation on extension of credit to retailers listed on attached copies of NRS 369.485? Yes (3) References: Name Address No (4) Has applicant a county license? Yes No A city or town license? Yes No (5) At all times each importer shall keep on hand at a fixed place of business in Nevada, liquor of a wholesale value of at least $1,000.00, pursuant to NRS 369.400. Signed ............................................................................................ Title................................................................................................ Remarks and recommendations by the County Commissioners: ............................................................................................................................................................................................ ............................................................................................................................................................................................ ............................................................................................................................................................................................ ............................................................................................................................................................................................ ............................................................................................................................................................................................ ............................................................................................................................................................................................ The application of .............................................................................................................................................................. is hereby (approved) (disapproved) this............................ day of .......................................................................... 20 .............. Board of County Commissioners: Chairman ....................................................................................... Member .......................................................................................... Member .......................................................................................... Member .......................................................................................... Member .......................................................................................... ATTEST: ............................................................................................ , County Clerk SCHEDULE OF LICENSE FEES The following is a schedule of fees to be charged for licenses: Importer of wine, beer and spirits ------------------------------- $500.00 Importer of beer ------------------------------------------------------ 150.00 Wholesaler of wine, beer and spirits ---------------------------- 250.00 Wholesaler of beer ---------------------------------------------------- 75.00 NRS 369.310 License fees: Due dates; payment of proportionate part. All license fees are due and payable on July 1 of each year. If not paid by July 15 of each year the license shall be canceled. If any license is issued at any time during the year other than by July 15, the fee shall be for that proportionate part of the year that the licenser will be in effect, which in any event shall be for not less than one quarter of a year. No license shall be dated other than on the first day of the month in which it is granted. American LegalNet, Inc. www.FormsWorkFlow.com 1. 2. 3.
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