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For Hire Carrier Application To Deliver Malt Beverages Wine Or Cider - Oregon

For Hire Carrier Application To Deliver Malt Beverages Wine Or Cider Form. This is a Oregon form and can be used in Liquor Control Commission Statewide .
 Fillable pdf Last Modified 3/2/2009
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OREGON LIQUOR CONTROL COMMISSION FOR-HIRE CARRIER APPLICATION TO DELIVER MALT BEVERAGES, WINE, OR CIDER A for-hire carrier must receive approval from the Commission before delivering any malt beverage, wine, or cider to a licensee of the Oregon Liquor Control Commission or to a resident of Oregon. A "for-hire carrier" is any person or company who holds itself out to the public as willing to transport property in return for compensation. The term "for-hire carrier" includes common carriers. Applicant Name: ___________________________________________________________ ____________ _ ___ Trade Name: __________________________________________________________ ___ ___ __________ _____ Business Address: _________________________________________ _______________________________ Street Address City/State/ZIP Mailing Address: _________________________________________ _____________________ ____________ Street Address City/State/ZIP Contact Person: ____________________________________________ Phone: _________________ ___ ___ I am requesting approval to deliver malt beverages, wine, or cider to Oregon residents and to licensees of the Oregon Liquor Control Commission, as authorized by Oregon Administrative Rule (OAR) 845-005-0424. Alcohol Delivery Plan (check one of the following): K K My signed and dated alcohol delivery plan is attached on a separate document. The plan meets OLCC's delivery requirements for residential deliveries under OAR 845-005-0424; or I will use the following plan for delivering malt beverages, wine, or cider to Oregon residents: · · · · · · · Only persons age 18 or over will be used to deliver the alcohol to the resident. The person who delivers the alcohol will verify by inspecting government-issued photo identification that the person receiving the alcohol is at least 21 years of age. The person who delivers the alcohol will verify that the person receiving the alcohol is not visibly intoxicated. If the alcohol is delivered on the same day the order is received, the alcohol is delivered before 9:00 p.m. The alcohol will only be delivered to a home or business where the home or business has a permanent street address. Any package containing alcohol is conspicuously labeled with the words "Contains alcohol: signature of person age 21 years or older required for delivery". The person delivering the alcohol to the resident of Oregon will collect information that will be retained by me for a minimum of 18 months from the date of delivering the alcohol. The information will include: The date and time the alcohol was delivered to the resident; and The name or information which can be used to determine the name of the person delivering the alcohol to the resident; and The name, signature, and delivery address of the person receiving the alcohol. page 1 of 3 1-800-452-6522 www.oregon.gov/olcc (rev. 07/2008) American LegalNet, Inc. www.FormsWorkflow.com FOR-HIRE CARRIER APPLICATION By signing below, I affirm that: CONTINUED FROM PAGE 1 · · · I understand the requirements for delivering wine, malt beverages and cider to Oregon residents and licensees; and I will follow my OLCC approved alcohol delivery plan when delivering malt beverages, wine, or cider to Oregon residents; and I will allow the Commission to audit my records which are directly related to alcohol deliveries in the state of Oregon upon request and shall make those records available to the Commission in Oregon. I understand that I must make these records available to the Commission no later than 60 days after the Commission mails the notice; and I consent to the Commission's jurisdiction and to the jurisdiction of the courts of the State of Oregon for the purpose of enforcing the provisions of OAR 845-005-0424 and any related laws or rules; and I understand that the Commission may revoke its approval of my delivery plan if I don't follow the plan approved by the Commission or if I don't comply with the provisions of OAR 845-005-0424. · · Applicant Signature: ________________________________________________ Date: _______________ Please send the completed form to: OLCC Metro Licensing Unit P.O. Box 22297 Milwaukie, OR 97269 OLCC use only Approved by: _____________________________________________________ Date: ______________ page 2 of 3 American LegalNet, Inc. www.FormsWorkflow.com 845-005-0424 Guidelines for Approval of a For-Hire Carrier's Plan for Delivery of Malt Beverages, Wine or Cider The Commission will evaluate and may approve a for-hire carrier's plan to deliver malt beverages, wine and cider to a resident of Oregon and licensees of the Commission. (1) Delivery to a resident of Oregon. In order to deliver malt beverages, wine or cider to a resident of Oregon, a for-hire carrier must make application to the Commission upon forms to be furnished by the Commission and receive approval from the Commission before delivering any malt beverages, wine or cider to a resident of Oregon. The application shall include the for-hire carrier's plan for ensuring that: (a) Only persons age 18 or over will be used to deliver the alcohol to the resident; (b) The person used to deliver the alcohol will verify by inspecting government-issued photo identification that the person receiving the alcohol is at least 21 years of age; (c) The person used to deliver the alcohol will determine that the person receiving the alcohol is not visibly intoxicated; (d) If the alcohol is delivered on the same day the order is received, the alcohol must be delivered before 9:00 pm; (e) The alcohol is delivered only to a home or business where the home or business has a permanent street address; (f) Any package containing alcohol is conspicuously labeled with the words "Contains alcohol: signature of person age 21 years or older required for delivery" or similar language approved by the Commission; and (g) Information is collected that must be retained by the for-hire carrier for a minimum of eighteen months from the date of delivering the alcohol. The information may be collected and retained electronically (if the carrier so chooses) and must include: (A) The date and time the alcohol was delivered to the resident; (B) The name or information which can be used to determine the name of the person delivering the alcohol to the resident; and (C) The name, signature, and delivery address of the person receiving the alcohol. (2) Delivery to a licensee of the Commission. In order to deliver malt beverages, wine or cider to a licensee of the Commiss
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