Caterers Permit Application {AB-04} | Pdf Fpdf Docx | Alaska
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Caterers Permit Application {AB-04} | Pdf Fpdf Docx | Alaska

Caterers Permit Application {AB-04}

This is a Alaska form that can be used for Alcoholic Beverage Control Board within Statewide.

Alternate TextLast updated: 10/22/2018

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[ Form AB - 0 4 ] (rev 08/10/2018 ) Page 1 of 5 Alaska Alcoholic Beverage Control Board Form AB - 0 4 : Caterer222s Permit Application Alcohol and Marijuana Control Office 550 W 7th Avenue, Suite 1600 Anchorage, AK 99501 amco.permits@alaska.gov https://www.commerce.alaska.gov/web/amco Phone: 907.269.0350 What is this form? This caterer222s permit application form is required for the holder of a beverage dispensary license to sell or dispense alcoholic beverages at a convention, picnic, social gathering, sporting event, or similar affair held off the holder222s licensed premises. A separate form must be completed for each event. All sections of this form must be completed. The required $50 caterer222s permit fee may be made by credit card, check, or money order. PLEASE NOTE: This form must be completed and submitted to AMCO222s main office in-person or to amco.permits@alaska.gov at least one business day in advance of the event. Applications submitted after 12:00pm on Fridays for events to be held the following Saturday or Sunday will be denied. Applications that are submitted with inaccurate or incomplete fields will be returned to the applicant in the manner in which it was received, per AS 04.11.230, 3 AAC 304.105, 3 AAC 304.675, and 3 AAC 304.685. Any event occurring in an outdoor location must have a written security plan attached to this form. This form must be signed by both the current licensee and by the law enforcement agency having jurisdiction over the site of the occasion for which this permit is sought before it is submitted to AMCO staff for review. If the completed application is approved by AMCO, a permit will be issued to the licensee for posting at the event. Enter information for the business seeking the permit. Licensee: License #: Doing Business As: Premises Address: City: State: Alaska ZIP: Contact Person: Contact Phone: Contact Email: OFFICE USE ONLY Permit #: Transaction #: Issue Date: OLE: Section 1 226 Licensee and Contact Information American LegalNet, Inc. www.FormsWorkFlow.com [ Form AB - 0 4 ] (rev 08/10/2018 ) Page 2 of 5 Alaska Alcoholic Beverage Control Board Form AB - 0 4 : Caterer222s Permit Application Alcohol and Marijuana Control Office 550 W 7th Avenue, Suite 1600 Anchorage, AK 99501 amco.permits@alaska.gov https://www.commerce.alaska.gov/web/amco Phone: 907.269.0350 Enter information regarding the specific event for which you are seeking a permit. Event Name: Event Description: Event Location: Event City: Date(s): Start Time: am pm End Time: am pm The licensee, or a specified employee or agent of the licensee, must be present on the catered premises during all permit hours, as required by 3 AAC 304.685. Please provide the following information for the licensee, employee, or agent who will be present: Person Present: Title: Location of Event: Yes No 1. Is this event going to take place on school or church grounds? If 223Yes224 to question 1, please attach authorization from the school or church for the service of alcohol during the event at the proposed location. 2. Are you anticipating, or in the process of applying for a liquor license for the event location? 3. Is there an existing liquor license of any type and ownership at the event location? If 223Yes224 to question 3, please provide the following information: License Type: License #: Doing Business As: Reason event held on an existing licensed premises: Section 2 226 Event Information American LegalNet, Inc. www.FormsWorkFlow.com [ Form AB - 0 4 ] (rev 08/10/2018 ) Page 3 of 5 Alaska Alcoholic Beverage Control Board Form AB - 0 4 : Caterer222s Permit Application Alcohol and Marijuana Control Office 550 W 7th Avenue, Suite 1600 Anchorage, AK 99501 amco.permits@alaska.gov https://www.commerce.alaska.gov/web/amco Phone: 907.269.0350 Clearly indicate the boundaries of the premises and the proposed permitted area within that property. Clearly indicate the interior layout of any enclosed areas on the proposed premises. Clearly identify all entrances and exits, walls, bars, and fixtures, and outline in red the perimeter of the areas designated for alcohol storage, service, and consumption. Include dimensions, cross-streets, and points of reference in your drawing. You may attach blueprints or other detailed drawings that meet the requirements of this form. Section 3 226 Detailed Premises Diagram American LegalNet, Inc. www.FormsWorkFlow.com [ Form AB - 0 4 ] (rev 08/10/2018 ) Page 4 of 5 Alaska Alcoholic Beverage Control Board Form AB - 0 4 : Caterer222s Permit Application Alcohol and Marijuana Control Office 550 W 7th Avenue, Suite 1600 Anchorage, AK 99501 amco.permits@alaska.gov https://www.commerce.alaska.gov/web/amco Phone: 907.269.0350 Enter information for all servers at the event. Additional copies of this page may be included. Name: AK Driver License #: Date of Birth: Alcohol Server Education Card Expiration Date: Name: AK Driver License #: Date of Birth: Alcohol Server Education Card Expiration Date: Name: AK Driver License #: Date of Birth: Alcohol Server Education Card Expiration Date: Name: AK Driver License #: Date of Birth: Alcohol Server Education Card Expiration Date: Name: AK Driver License #: Date of Birth: Alcohol Server Education Card Expiration Date: Name: AK Driver License #: Date of Birth: Alcohol Server Education Card Expiration Date: Name: AK Driver License #: Date of Birth: Alcohol Server Education Card Expiration Date: Name: AK Driver License #: Date of Birth: Alcohol Server Education Card Expiration Date: Name: AK Driver License #: Date of Birth: Alcohol Server Education Card Expiration Date: Name: AK Driver License #: Date of Birth: Alcohol Server Education Card Expiration Date: Section 4 226 Servers American LegalNet, Inc. www.FormsWorkFlow.com [ Form AB - 0 4 ] (rev 08/10/2018 ) Page 5 of 5 Alaska Alcoholic Beverage Control Board Form AB - 0 4 : Caterer222s Permit Application Alcohol and Marijuana Control Office 550 W 7th Avenue, Suite 1600 Anchorage, AK 99501 amco.permits@alaska.gov https://www.commerce.alaska.gov/web/amco Phone: 907.269.0350 Read each line below, and then sign your initials in the box to the right of each statement: Initials I certify that I am the current licensee, and that a licensee, employee, or agent will be present at the event during all hours of the permit. I certify that I will comply with all statutes, ordinances, and regulations pertaining to the possession and sale of alcoholic beverages, and I understand that violation of any of these laws is grounds for suspension or revocation of my beverage dispensary license and/or denial of any future permit applications. I certify that I understand that providing a false statement on this form or any other form provided by AMCO is grounds for rejection or denial of this application or revocation of any permit issued. As an applicant for a caterer222s permit and holder of a beverage dispensary license, I declare under penalty of perjury that I have read and am familiar with AS 04 and 3 AAC 304, and that this application, including all accompanying schedules and statements, is true, correct, and complete. Executed on this day of , 20. Signature of licensee Printed name of licensee Law Enforcement and AMCO Review: Approved Disapproved Signature of local law enforcement Badge number Printed name of local law enforcement Date Approved Disapproved Signature of Program Coordinator Signature of AMCO Investigator/Director Printed name of Program Coordinator Printed name of AMCO Investigator/Director Date AMCO Comments: Section 5 226 Declarations and Approvals American LegalNet, Inc. www.FormsWorkFlow.com

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