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On Premise Transfer Application - Maine

On Premise Transfer Application Form. This is a Maine form and can be used in Liquor Licensing And Inspection Division Statewide .
 Fillable pdf Last Modified 12/4/2008
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STATE OF MAINE Department of Public Safety Liquor Licensing 164 State House Station Augusta, Maine 04333 ON PREMISE TRANSFER APPLICATION The undersigned, who is the holder on an On Premise Liquor License under the provisions of Title 28-A MRSA Section 605 hereby respectfully requests that said license be transferred from his present location: Street Address TO: ______________________________________________________________________________ Street Address Both premises being within the same municipality of: City/Town Has the premises for which the transfer is requested been licensed by the Department of Human Services? Yes No How many feet to the nearest school, school dormitory, church, chapel or parish house?___________________________ Which of the above is nearest?____________________________________________________________________ Permanent License #:___________________________ Expiration Date:__________________________________ Name of Business:____________________________________________________________________________ Contact Person:_________________________________Requested Transfer Date:__________________________ Telephone Number: ____________________________ FAX Number:___________________________________ Dated at:_________________________________________ On ___________________________, 20________ City/Town, State Date ______________________________________________ ______________________________________________ Signature of Individual(s), or Duly Authorized Officer(s) of Corporation, or if Partnership, by Members of Partnership STATE OF MAINE Dated at:___________________________________, Maine___________________________________ss City /Town On:________________________________________ The undersigned being: City Town Municipal Officers Unincorporated Place County County Commissioners of the of:_______________________________________________ ______________________________________________ _______________________________________________ OnPremTransApp/2008 _______________________________________________ _______________________________________________ Office Located at CENTRAL MAINE COMMERCE CENTER 45 Commerce Drive Suite 1, AUGUSTA, ME 04330 (207) 624-7223 and 624-7224 Licensing and Inspections (207) 624-7230 Referrals and Training American LegalNet, Inc. www.FormsWorkflow.com (207) 287-3424 FAX
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