ALCOHOL BEVERAGE LICENSE New License Application

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "ALCOHOL BEVERAGE LICENSE New License Application"

Transcription

1 New License Application Attached is the application and additional documents to apply for a new Alcohol Beverage License. Please complete forms and instructions as indicated. For detail on the City of Milton s regulations on alcohol licenses, please refer to the City of Milton Code of Ordinances, Chapter 4: Alcoholic Beverages (available at or call Date: Contact Name: Contact Phone: Business Name: DBA (If applicable): Before submitting your application, please initial that all check-list items have been completed. 1. Application sworn by applicant before notary public or other officer authorized to administer oaths, accompanied by check or money order for advertising, background check, and license fees. 2. Complete the GCIC (Georgia Crime Information Center) consent form. Each manager and all persons owning twenty percent (20%) or more of the business must complete this form and provide a photocopy of a valid picture ID. 3. Complete Land Survey form and attach a site map of the business location. 4. Sign Application Affidavit. 5.Complete and sign SAVE Affidavit. 6. Obtain copy of City of Milton Ordinance regarding Alcoholic Beverages. 7. Obtain copy of application and training schedule regarding Pouring Permits. Applicant Signature City of Milton Representative

2 Alcohol Fee Schedule Administrative Fees: Application Fee $100 Advertising Fee $200 Sign Fee $98 GCIC Background Check per person x $35 (Number) Consumption on Premises: Wine Malt Beverages Wine and Malt Beverages Distilled Spirits Wine, Malt Beverages and Distilled Spirits Additional Bar Package: Wine Malt Beverages Wine and Malt Beverages Distilled Spirits Wine, Malt Beverages and Distilled Spirits $650 $650 $1,300 $3,200 $4,500 $1,000 $400 $400 $800 $3,000 $3,800 Total Fees Due: Administrative Fees: License Fees: Total Amount Due:

3 Application BUSINESS INFORMATION: Name: (DBA if applicable) Business Address: Business Phone: Fed Tax ID: Fax: No. of Employees: OWNER/LICENSEE: Name: (Corporate Name or Individual) Mailing Address: (if different than above) Cell/ Home phone: Social Security No. Date of Birth: / / Dr. License No. TYPE OF OWNERSHIP: Proprietorship Corporate Non Profit Other (specify) Partnership For Profit LLC TYPE OF LICENSE: Wine & Malt Beverage Wine Additional Bar Malt Beverage Distilled Spirits Sunday Sales Brew Pub LICENSE SUB-TYPE: Package Consumption on Premises LOCATION: Restaurant Bar/ Lounge Service Station Private Food Store Supermarket Hotel/ Motel Liquor Store Other/ Specify

4 If you operate as a corporation, please complete the information below: TITLE NAME HOME ADDRESS CITY/ST/ZIP President: Vice Pres. Secretary: Treasurer Please circle or fill out appropriate answer: 1. Is this application as a result of a change in ownership? Yes No (If yes, detail change which occurred and date change occurred.) 2. Does applicant own property where business is located? Yes No (If no, name owners and/or person to whom rent is paid, including address and telephone number(s). 3. Are charges for any offenses presently pending (excluding traffic offenses not related to alcohol) against the named licensee or any other person(s) affiliated with this license? (If yes, please outline details below.) Name: Charge: Where Convicted: Date: 4. Are the business owner(s) associated in any way with other retail, wholesaler, manufacturing, or distiller of alcoholic beverage? (If yes, give names and address.) Name: Name: Address: Address:

5 Report of Land Survey This form must be signed by Georgia Registered Land Surveyor and returned with a boundary line survey clearly indicating that the proposed retail establishment meets Milton s City Code of Ordinances regarding distance requirements. The attached boundary line survey should be prepared by a Georgia Registered Land Surveyor and include the following information. Building location within boundaries of property. Indicate location of main/front entrance of building to determine appropriate distance requirements. Name, address, and telephone number of applicant. Date of survey, graphic scale, and north arrow. Location of attract (land district and land lot) and acreage. Signature and certification statements as listed below on survey for related alcoholic beverage use. Include one (1) of the certification statements as listed below on survey for related alcoholic beverage use. 1. Certified that RETAIL SALES (Distilled Sprits) is not located within 100 yards of a church building or within 200 yards of any school building, educational building, school grounds, or college campus. 2. Certified that RETAIL SALES (Wine or Malt Beverage) is not located within 100 yards of any school building, school grounds, or college campus. Business Name (Business applying for license) Location Address Surveyor Name (printed) Signature Company Date

6 Contact Information Wholesalers Name Business Address Business Phone (If more, please indicate on the back of this form) Solid Waste Haulers (for restaurants only) Name Business Address Business Phone (If more, please indicate on the back of this form)

7 Consent Form for GCIC Records Check Please make copies as necessary (This must be completed for each manager and all persons owning twenty percent or more of the business) Full Name Date Maiden Name/ Previous Name / / Date of Birth Gender Race - - Social Security Number Street Address City County State Zip Business Name Business Address I authorize the Milton Public Safety Department to receive any criminal history record information pertaining to me, which may be in the files of any federal, state, and/or city criminal justice agency in Georgia. Signature Date For office use only: GCIC Officer: Record Attached: Chief of Police: Date Completed: No Record:

8 Application Affidavit TO BE SIGNED BY BUSINESS OWNER AND A NOTARY OF THE PUBLIC Under penalty provided by law, the applicant states that each of the above questions has been truthfully answered to the best of the knowledge of the singers. Signers agree to operate their business according to the law and that the rights and responsibilities conferred by the license(s), if granted will not be assigned to another. The applicant agrees to notify the Treasurer s Office of any change as it applies to this application within thirty (30) days of change. Failure to make such amendments shall be cause for the revocation 0f any license issued pursuant to this application. Further, the applicant agrees to abide by all laws, rules, and regulations of the Unites States, the State of Georgia, and of the City of Milton, now in force or which may hereafter be enacted, which regulate and govern the sale of alcoholic beverages and liquors. The applicant understands that issuance of license hereby applied for be granted, shall be constituted only as a privilege and not a right and that said license may be revoked or suspended by the city Manager, Milton, Georgia. The applicant also fully understands that any license issued shall cover the period of one (1) year commencing the 1 st day of January and expiring December 31 st. All license fees are nonrefundable. As an applicant for Alcohol Beverage License, I understand that my license application will be publicly advertise and presented to the City Council for approval at one public hearing. The undersigned, being first duly sworn on oath, deposes and says that he/she is the person named in the foregoing application; that the applicant has read and made a complete answer to each questions, and that the answers in each instance are true and correct. The undersigned further understands that any license issued contrary to state laws and city ordinances of Milton, Georgia shall be void, and under penalty of state law, the applicant may be prosecuted for submitting false statement and affidavits in connection with this application. Subscribed and sworn to before me this day of, 20. My commission expires; Clerk/ Notary Public Signature of applicant Printed

9 STATE OF GEORIGA } CITY OF MILTON } AFFIDAVIT OF PRESENCE IN THE UNITED STATES O.C.G.A Personally appeared before me, the undersigned deponent on the day of, 20 who being duly sworn deposes and says on oath that: My name is. I suffer no mental disabilities. I am able and competent to testify to the information and statements contained in this affidavit. I have read this affidavit, or have had it read to me, and I fully understand its contents. I am executing this affidavit for purposes of compliance with O.C.G.A [INITIAL AND CHECK APPROPRIATE STATEMENT] I am a United States citizen 18 years of age or older. I am a non-citizen who is a legal permanent resident, qualified alien or nonimmigrant under the federal Immigration and Nationality Act 18 years of age or older lawfully present in the United States. Provide Alien Number: * In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section of the Official Code of Georgia. Signed and sealed in the presence of: Affiant: Notary Public My Commission Expires: Signature Printed Name [Notary Seal] *Note: O.C.G.A (e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8 U.S.C., as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of alien, legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identifying number below:

10 Additional Information Advertisement The City of Milton accepts an advertising fee for advertising the agenda items for alcohol licenses and public hearing dates in the Milton Herald. Signage After the application has been processed, the applicant is required to post a sign in front of their business advertising the date of the approval hearing. The City of Milton will prepare the sign through its approved vendor. The applicant is responsible to make payment to the City at the time of application for the sign and to ensure that the sign is posted not less than fifteen days before the hearing s date. Hours of Sale Package Retail- Beer, Wine, and Liquor Chapter 7, Article 4, Section 2 and Article 5 Sunday 12:30 PM - 11:30 PM Monday- Saturday 7:00 AM- 12:00 (Midnight) Consumption on Premises- Beer, Wine, and Liquor Chapter 7, Article V, Division 2, Section 233and Division 3, Section 255 Eating Establishments ONLY- establishment which is licensed to sell alcoholic beverages and which derives at least fifty percent (50%) of its total annual gross food and beverages sales from the sale of prepared meals of food. Sunday 12:30 PM- 2:00 AM (Following Day) Monday- Saturday 9:00 AM- 2:00 AM No sales permitted on Christmas Day. Not allowed within 250 feet of polling places on Election Days. Private Clubs Chapter 7, Article V, Division 6, Section 319 The sale of beer and/or wine for consumption on the premises is permitted in any licensed establishment which derives at least fifty percent (50%) of its total annual gross sales from the sale of prepared meals or foods in all the combined retail outlets of the individual establishment where food is served. Sunday 12:30 PM- 12:00 (Midnight) Monday- Saturday 9:00 AM- 4:00 AM

CITY OF ST. MARYS, GEORGIA 418 Osborne Street St. Marys, GA 31558 (912) 510-4039 ITEMS TO BE SUBMITTED WITH THE APPLICATION FOR A NEW ALCOHOL LICENSE

CITY OF ST. MARYS, GEORGIA 418 Osborne Street St. Marys, GA 31558 (912) 510-4039 ITEMS TO BE SUBMITTED WITH THE APPLICATION FOR A NEW ALCOHOL LICENSE CITY OF ST. MARYS, GEORGIA 418 Osborne Street St. Marys, GA 31558 (912) 510-4039 ITEMS TO BE SUBMITTED WITH THE APPLICATION FOR A NEW ALCOHOL LICENSE (1) Complete and accurate application form. NOTE: Incomplete

More information

CITY OF ST. MARYS, GEORGIA 418 Osborne Street St. Marys, GA 31558 (912) 510-4039 ITEMS TO BE SUBMITTED WITH THE APPLICATION FOR A NEW ALCOHOL LICENSE

CITY OF ST. MARYS, GEORGIA 418 Osborne Street St. Marys, GA 31558 (912) 510-4039 ITEMS TO BE SUBMITTED WITH THE APPLICATION FOR A NEW ALCOHOL LICENSE CITY OF ST. MARYS, GEORGIA 418 Osborne Street St. Marys, GA 31558 (912) 510-4039 ITEMS TO BE SUBMITTED WITH THE APPLICATION FOR A NEW ALCOHOL LICENSE (1) Complete and accurate application form. NOTE: Incomplete

More information

May be furnished by any three (3) persons who have known the applicant (agent) for at least three (3) years. Include name, address & phone number.

May be furnished by any three (3) persons who have known the applicant (agent) for at least three (3) years. Include name, address & phone number. Two Original Applications Personal History Form Lease or Valid Document Photographs Corporate Papers Letters of Reference Financial Investments Please write legibly in BLACK ink or type information. Answer

More information

New Application for Business Occupational Tax Certificate

New Application for Business Occupational Tax Certificate New Application for Business Occupational Tax Certificate YEAR Business Name: Business Telephone Number: Fax Number: Business Address (physical location): Suite or Apt No.: City, State, Zip: E-mail: Type

More information

OCCUPATIONAL TAX CERTIFICATE

OCCUPATIONAL TAX CERTIFICATE 3725 Park Avenue Doraville, GA 30340 770/451-8745 This application is for administrative use in determining occupational taxes only. It does not grant any rights to operate a business contrary to any City

More information

TOWN OF OGUNQUIT NEW LIQUOR LICENSE APPLICATION

TOWN OF OGUNQUIT NEW LIQUOR LICENSE APPLICATION TOWN OF OGUNQUIT NEW LIQUOR LICENSE APPLICATION For the year APPLICANT (S) BUSINESS Name in full Business Name, d/b/a, etc. Home Street Address Location (Do t Use PO Box Number) City of Town State Zip

More information

2016-2017 Liquor License Application Applicant Name:

2016-2017 Liquor License Application Applicant Name: Cook County Liquor Control Commission 118 N. Clark Street, Room 1160 Chicago, Illinois 60602 (312) 603-3727 (312) 603-5771 (fax) Toni Preckwinkle President Cook County Board of Commissioners Zahra Ali

More information

Solicitor Permit Application

Solicitor Permit Application Solicitor Permit Application The City of Dunwoody has established the following application to allow for registration of persons, firms, or corporations to engage in the business of soliciting or calling

More information

2. Personal History Form Complete one Personal History form.

2. Personal History Form Complete one Personal History form. 1. Two Original Applications Please write legibly in BLACK ink or type information. Answer all questions appropriately and in detail. Applications must be signed, dated, and notarized. 2. Personal History

More information

CITY OF CARBONDALE, ILLINOIS LOCAL LIQUOR CONTROL COMMISSION CITY ALCOHOLIC LIQUOR LICENSE

CITY OF CARBONDALE, ILLINOIS LOCAL LIQUOR CONTROL COMMISSION CITY ALCOHOLIC LIQUOR LICENSE CITY OF CARBONDALE, ILLINOIS LOCAL LIQUOR CONTROL COMMISSION CITY ALCOHOLIC LIQUOR LICENSE TO THE LOCAL LIQUOR CONTROL COMMISSION: The undersigned hereby makes application for the issuance of a city retailer's

More information

COMMERCIAL OCCUPATIONAL TAX APPLICATION

COMMERCIAL OCCUPATIONAL TAX APPLICATION CUSTOMER SERVICE DEPARTMENT (770) 917-8903 - Fax (678) 801-4035 P. O. Box 636, Acworth, GA 30101 COMMERCIAL OCCUPATIONAL TAX APPLICATION (REQUIREMENTS FOR OBTAINING COMMERCIAL OCCUPATIONAL TAX CERTIFICATE

More information

CITY OF NICHOLASVILLE ALCOHOLIC BEVERAGE CONTROL LICENSE APPLICATION

CITY OF NICHOLASVILLE ALCOHOLIC BEVERAGE CONTROL LICENSE APPLICATION CITY OF NICHOLASVILLE ALCOHOLIC BEVERAGE CONTROL LICENSE APPLICATION Revised 3-27-2015 Page 1 of 6 CITY OF NICHOLASVILLE ALCOHOLIC BEVERAGE CONTROL 517 NORTH MAIN STREET, NICHOLASVILLE, KY 40356 (859)

More information

7-1 TITLE 9 BUSINESS REGULATIONS 7-3

7-1 TITLE 9 BUSINESS REGULATIONS 7-3 7-1 TITLE 9 BUSINESS REGULATIONS 7-3 Sec. 7-1: Sec. 7-2: Sec. 7-3: Sec. 7-4: Sec. 7-5: Sec. 7-6: Sec. 7-7: Sec. 7-8: Sec. 7-9: Sec. 7-10: Sec. 7-11: Sec. 7-12: Sec. 7-13: Sec. 7-14: Sec. 7-15: Sec. 7-16:

More information

GEORGIA BOARD OF PHARMACY 2 Peachtree Street, N.W. 36 th Floor Atlanta, Georgia 30303

GEORGIA BOARD OF PHARMACY 2 Peachtree Street, N.W. 36 th Floor Atlanta, Georgia 30303 GEORGIA BOARD OF PHARMACY 2 Peachtree Street, N.W. 36 th Floor Atlanta, Georgia 30303 PHARMACY TECHNICIAN INFORMATION SHEET AND CHECKLIST In accordance with O.C.G.A. 26-4-28, the Georgia Board of Pharmacy

More information

CHAPTER 111: ALCOHOLIC BEVERAGES. General Provisions

CHAPTER 111: ALCOHOLIC BEVERAGES. General Provisions CHAPTER 111: ALCOHOLIC BEVERAGES Section General Provisions 111.01 Definitions 111.02 License required to sell liquor 111.03 Applications for licenses 111.04 When license shall not be issued 111.05 Termination

More information

CHAPTER III. BEVERAGES

CHAPTER III. BEVERAGES CHAPTER III. BEVERAGES ARTICLE 2. ALCOHOLIC LIQUOR SECTIONS 3-201 DEFINITIONS 3-202 CURRENT STATE LICENSE 3-203 POSTING OF RECEIPT 3-204 HOURS OF OPERATION FOR RETAIL 3-205 PENALTY 3-206 UNLAWFUL ACTS;

More information

INFORMATION AND INSTRUCTION FOR NONRESIDENT SELLER S PERMIT, NONRESIDENT BREWER S PERMIT, AND NONRESIDENT MANUFACTURER S LICENSE

INFORMATION AND INSTRUCTION FOR NONRESIDENT SELLER S PERMIT, NONRESIDENT BREWER S PERMIT, AND NONRESIDENT MANUFACTURER S LICENSE FORM L103A (05/2015) INFORMATION AND INSTRUCTION FOR NONRESIDENT SELLER S PERMIT, NONRESIDENT BREWER S PERMIT, AND NONRESIDENT MANUFACTURER S LICENSE NONRESIDENT SELLER S PERMIT (S) (Wine, Distilled Spirits)

More information

City of Sugar Hill A n: Kaipo Awana 5039 West Broad Street Sugar Hill, GA 30518

City of Sugar Hill A n: Kaipo Awana 5039 West Broad Street Sugar Hill, GA 30518 This summer, the World Changers Organiza on, Sugar Hill Housing Authority and City of Sugar Hill, are teaming up for our annual community development program. About 200 youth and young adult volunteers

More information

Village of Huntley. Not-For-Profit. Liquor License. Application

Village of Huntley. Not-For-Profit. Liquor License. Application Not-For-Profit Liquor License Application Village Contact Information Rita McMahon Village Clerk 847-515-5261 rmcmahon@huntley.il.us Application INSTRUCTIONS: Every question must be answered. Illegible

More information

Oklahoma Board of Dentistry

Oklahoma Board of Dentistry Susan Rogers, Esq. Executive Director Mary Fallin Governor Oklahoma Board of Dentistry HYGIENE APPLICATIONS BY EXAM APPLICATION PROCESS: 1. Submit a completed application; include the non-refundable fee

More information

APPLICATION FOR DOMESTIC RECIPROCITY LICENSE. The State Board of Cosmetology may grant license by reciprocity, without examination, if:

APPLICATION FOR DOMESTIC RECIPROCITY LICENSE. The State Board of Cosmetology may grant license by reciprocity, without examination, if: 2401 NW 23rd Street, Suite 84 Reciprocity Department 405.522.7620 Fax 405.521.2440 MARY FALLIN GOVERNOR SHERRY G. LEWELLING EXECUTIVE DIRECTOR APPLICATION FOR DOMESTIC RECIPROCITY LICENSE The State Board

More information

VEHICLE FOR HIRE COMPANY APPLICATION (VEHICLE PERMITS) NOT TAXICAB

VEHICLE FOR HIRE COMPANY APPLICATION (VEHICLE PERMITS) NOT TAXICAB Administration & Regulatory Affairs Department Regulatory Affairs Division 1002 Washington Ave. Houston Texas 77002 Phone: (832) 394-8803 Fax: (832)395-9632 Monday through Friday -- 8:00AM until 4:30PM

More information

APPLICATION FOR LICENSURE AS AN INSTALLMENT SELLER

APPLICATION FOR LICENSURE AS AN INSTALLMENT SELLER APPLICATION FOR LICENSURE AS AN INSTALLMENT SELLER PART 1 The Pennsylvania Department of Banking and Securities (the Department) welcomes your request for this Installment Seller application. It is the

More information

OCCUPATIONAL TAX APPLICATION CHECKLIST

OCCUPATIONAL TAX APPLICATION CHECKLIST The City of Snellville Department of Planning & Development 2342 Oak Road (770) 985-3513 Snellville, GA 30078 (770) 985-3514 www.snellville.org FAX (770) 985-3551 _ Rev. 06-01-2015 OCCUPATIONAL TAX APPLICATION

More information

CITY OF LITTLE CANADA APPLICATION FOR MASSAGE THERAPY ESTABLISHMENT LICENSE

CITY OF LITTLE CANADA APPLICATION FOR MASSAGE THERAPY ESTABLISHMENT LICENSE CITY OF LITTLE CANADA APPLICATION FOR MASSAGE THERAPY ESTABLISHMENT LICENSE Massage Therapy Principal Use License Fee $300 Massage Therapy Accessory Use License Fee $100 (Accessory or incidental use to

More information

COMMERCIAL, BUSINESS INFORMATIONAL. PACKET

COMMERCIAL, BUSINESS INFORMATIONAL. PACKET COMMERCIAL, BUSINESS INFORMATIONAL. PACKET BUSINESS:. _ CHECKLIST FOR A NEW COMMERCIAL BUSINESS : REQUIRED ITEMS: Complete a Business License Inspection and Clearance Form. This form is used by our office

More information

**Additional information may be requested at the discretion of the Board.**

**Additional information may be requested at the discretion of the Board.** Oklahoma State Board of Dentistry 2920 N Lincoln Blvd., Ste. B OKC, OK 73105 (405)522-4844 Oklahoma State Board of Dentistry CHECKLIST- DDS/ SPECIALTY/ RDH BY CREDENTIALS *In order to be eligible for licensure

More information

BUREAU OF INSURANCE STATE CORPORATION COMMISSION P.O. BOX 1157 RICHMOND, VA 23218

BUREAU OF INSURANCE STATE CORPORATION COMMISSION P.O. BOX 1157 RICHMOND, VA 23218 BUREAU OF INSURANCE STATE CORPORATION COMMISSION P.O. BOX 1157 RICHMOND, VA 23218 INSTRUCTIONS FOR COMPLETING THE INITIAL REINSURANCE INTERMEDIARY LICENSE APPLICATION GENERAL l. All responses except for

More information

NORTH CAROLINA ALCOHOLIC BEVERAGE CONTROL COMMISSION Location: 400 EAST TRYON ROAD RALEIGH NC 27610 (919) 779-0700 abc.nc.gov

NORTH CAROLINA ALCOHOLIC BEVERAGE CONTROL COMMISSION Location: 400 EAST TRYON ROAD RALEIGH NC 27610 (919) 779-0700 abc.nc.gov I. INSTRUCTIONS NORTH CAROLINA ALCOHOLIC BEVERAGE CONTROL COMMISSION Location: 400 EAST TRYON ROAD RALEIGH NC 27610 (919) 779-0700 abc.nc.gov MAIL TO ADDRESS ON BACK OF FORM HOW TO APPLY FOR AN ABC RETAIL

More information

City of Somerset Office of Alcoholic Beverage Control

City of Somerset Office of Alcoholic Beverage Control Application Instructions Please fill out each section of both the state and local application. Fill out one application for each license All documents required for a state license should accompany this

More information

CLASS A LICENSE RENEWAL APPLICATION

CLASS A LICENSE RENEWAL APPLICATION - BINGO - INSTRUCTIONS CLASS A LICENSE RENEWAL APPLICATION Pinellas County Code, Chapter 10 requires charitable organizations and authorized organizations holding a Class A Bingo License to apply to renew

More information

APPLICANTS SHOULD SUBMIT AN APPLICATION TO THE ABC BOARD PRIOR TO RETURNING THIS APPLICATION TO THE CITY OF MOBILE REVENUE DEPARTMENT.

APPLICANTS SHOULD SUBMIT AN APPLICATION TO THE ABC BOARD PRIOR TO RETURNING THIS APPLICATION TO THE CITY OF MOBILE REVENUE DEPARTMENT. CITY OF MOBILE MOBILE, ALABAMA ALCOHOLIC BEVERAGE APPLICATION ***APPOINTMENT REQUIRED*** ATTACHED IS A PACKET WHICH MUST BE COMPLETED AND ORIGINALS RETURNED TO THE CITY OF MOBILE REVENUE DEPARTMENT IN

More information

LICENSE FEE: $300 fee must be submitted at the time of application. Make checks payable to: City of Milwaukee.

LICENSE FEE: $300 fee must be submitted at the time of application. Make checks payable to: City of Milwaukee. ccl-160 (12/10) PRIVATE ALARM BUSINESS LICENSE INFORMATION SHEET OFFICE OF THE CITY CLERK LICENSE DIVISION 200 E. WELLS ST. ROOM 105, MILWAUKEE, WI 53202 (414) 286-2238 E-MAIL ADDRESS: LICENSE@MILWAUKEE.GOV

More information

Residential: Commercial:

Residential: Commercial: Effective 01/01/15 2015 UTILITY [WATER & SEWER] SERVICES APPLICATION NEW PROJECT: RENEWAL: Residential: Commercial: For Residential Connections: Customer Name: Mailing Address: City, County, State, Zip

More information

Select: New Renewal New Owner. Type of Business: Individual Corporation LLC Partnership LLP, Trust or Other. Drinking Establishment/Hotel/Caterer

Select: New Renewal New Owner. Type of Business: Individual Corporation LLC Partnership LLP, Trust or Other. Drinking Establishment/Hotel/Caterer www.wichita.gov State License No Expiration Date Allow 30 days for Approval CITY LICENSING 455 N. Main, 1 st Floor Wichita, KS 67202 (316) 268-4553 Select: New Renewal New Owner Type of Business: Individual

More information

CITY OF AURORA CITY COUNCIL ORDINANCE NUMBER DATE OF PASSAGE

CITY OF AURORA CITY COUNCIL ORDINANCE NUMBER DATE OF PASSAGE DRAFT PETITIONER: The City of Aurora ORDINANCE NUMBER DATE OF PASSAGE CITY OF AURORA CITY COUNCIL AN ORDINANCE AMENDING CHAPTER 25 OF THE CITY OF AURORA CODE OF ORDINANCES TO ADD A NEW ARTICLE XI THERETO

More information

The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health Division of Health Professions Licensure

The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health Division of Health Professions Licensure The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health Division of Health Professions Licensure Board of Registration in Pharmacy 239 Causeway Street,

More information

CHARTER SIGHTSEEING LICENSE APPLICATION

CHARTER SIGHTSEEING LICENSE APPLICATION Rahm Emanuel Mayor City of Chicago Department of Business Affairs and Consumer Protection Public Vehicle Operations Division 2350 West Ogden Avenue, 1st Floor Chicago, Illinois 60608 (312) 746-4200 (312)

More information

CORPORATE SURETY LICENSE APPLICATION

CORPORATE SURETY LICENSE APPLICATION CORPORATE SURETY LICENSE APPLICATION WILLIAMSON COUNTY BAIL BOND BOARD WILLIAMSON COUNTY DISTRICT ATTORNEY S OFFICE GEORGETOWN, TEXAS New Application Renewal Application NO APPLICATION SHALL BE DEEMED

More information

INFORMATION SHEET FOR AUTHORIZATION AS AN ADVANCED PRACTICE REGISTERED NURSE GENERAL INFORMATION

INFORMATION SHEET FOR AUTHORIZATION AS AN ADVANCED PRACTICE REGISTERED NURSE GENERAL INFORMATION GEORGIA BOARD OF NURSING Professional Licensing Boards Division 237 Coliseum Drive Macon, Georgia 31217 Telephone: (478) 207-2440 Fax: (877) 371-5712 Web Site: www.sos.georgia.gov/plb/rn INFORMATION SHEET

More information

Small Business Enterprises (SBE) Certification Application

Small Business Enterprises (SBE) Certification Application Small Business Enterprises (SBE) SBE Certification Program Information and Application Mission Statement: The Office of Business Opportunity is committed to creating a competitive and diverse Business

More information

NEW/RENEWAL APPLICATION FOR PAIN MANAGEMENT CLINIC REGISTRATION

NEW/RENEWAL APPLICATION FOR PAIN MANAGEMENT CLINIC REGISTRATION Department of Regulatory and Economic Resources Business Affairs Division Office of Consumer Protection 601 NW 1st Court, 18th Floor Miami, Florida 33136 Tel: 786-469-2300 Fax: 786-469-2311 email: license@miamidade.gov

More information

Clayton County Central Services 7994 North McDonough Street Jonesboro, Georgia 30236 Phone: (770) 477-3587 Fax: (770) 477-3335

Clayton County Central Services 7994 North McDonough Street Jonesboro, Georgia 30236 Phone: (770) 477-3587 Fax: (770) 477-3335 Clayton County Central Services 7994 North McDonough Street Jonesboro, Georgia 30236 Phone: (770) 477-3587 Fax: (770) 477-3335 CONTRACT COMPLIANCE DIVISION CENTRAL SERVICES DEPARTMENT MINORITY AND WOMAN-OWNED

More information

CITY OF LAKEVILLE THERAPEUTIC MASSAGE CENTER LICENSE APPLICATION (Type or Print)

CITY OF LAKEVILLE THERAPEUTIC MASSAGE CENTER LICENSE APPLICATION (Type or Print) CITY OF LAKEVILLE THERAPEUTIC MASSAGE CENTER LICENSE APPLICATION (Type or Print) Applicant/Owner Name First Middle Last Home Address Street City State Zip Phone Number Manager/Operator (If different than

More information

Town of Newbury, MA One-Day Liquor License Information

Town of Newbury, MA One-Day Liquor License Information APPLICATION DATE: Submittal Deadline: At least twenty-one (21) days prior to Event. MGL, CHAPTER 138, SECTION 14: The Local Licensing Authorities may issue special licenses for the sale of Wine and Malt

More information

Please be mindful that the most commonly omitted items from the New DUI Program Application are: Completed application for each stakeholder/ partner

Please be mindful that the most commonly omitted items from the New DUI Program Application are: Completed application for each stakeholder/ partner DUI Alcohol or Drug Use Risk Reduction Program Owner Checklist All applicants including partners, corporate officers, and/or controlling stockholders must sign the Statement of Completion at the bottom

More information

Initial Application for Debt Management License Attachments and Instructions

Initial Application for Debt Management License Attachments and Instructions FIS 0506 (05/15) Department of Insurance and Financial Services Page 1 of 3 Initial Application for Debt Management License Initial Application for Debt Management License Attachments and Instructions

More information

INSTRUCTION SHEET: APPLICATION FOR NON-CONSENSUAL TOWING PERMIT

INSTRUCTION SHEET: APPLICATION FOR NON-CONSENSUAL TOWING PERMIT Georgia Department of Public Safety MCCD, Regulations Compliance P.O. Box 1456 Atlanta, Georgia 30371-1456 (404) 624-7242 or (404) 624-7245 www.gamccd.net INSTRUCTION SHEET: APPLICATION FOR NON-CONSENSUAL

More information

CAREFULLY READ THE GENERAL INSTRUCTIONS FOR FILING AN F APPLICATION - ON PAGE 5

CAREFULLY READ THE GENERAL INSTRUCTIONS FOR FILING AN F APPLICATION - ON PAGE 5 OHIO DEPARTMENT OF COMMERCE, DIVISION OF LIQUOR CONTROL 6606 TUSSING ROAD REYNOLDSBURG, OHIO 43068-9005 Telephone No. (614) 387-7407 Fax No. (614) 644-6965 http://www.com.ohio.gov/liqr F PERMIT APPLICATION

More information

State of Utah DEPARTMENT OF COMMERCE DIVISION OF CONSUMER PROTECTION

State of Utah DEPARTMENT OF COMMERCE DIVISION OF CONSUMER PROTECTION State of Utah DEPARTMENT OF COMMERCE DIVISION OF CONSUMER PROTECTION CERTIFICATE OF POSTSECONDARY STATE AUTHORIZATION: PUBLIC NONPROFIT POSTSECONDARY SCHOOL APPLICATION (continuous operation for at least

More information

APPLICATION TO OPERATE A TRAUMATIC BRAIN INJURY FACILITY. SECTION A: IDENTIFICATION DATE OF APPLICATION: Original; Change of Status.

APPLICATION TO OPERATE A TRAUMATIC BRAIN INJURY FACILITY. SECTION A: IDENTIFICATION DATE OF APPLICATION: Original; Change of Status. APPLICATION TO OPERATE A TRAUMATIC BRAIN INJURY FACILITY Effective August 3, 2010, a fee must be paid for each new application, change of ownership, change of location, or renewal of license. Before you

More information

INSTRUCTIONS FOR CITY OF BOWLING GREEN ABC APPLICATION

INSTRUCTIONS FOR CITY OF BOWLING GREEN ABC APPLICATION INSTRUCTIONS FOR CITY OF BOWLING GREEN ABC APPLICATION A. Complete and submit appropriate State Application Forms. All State application forms and required fees should be returned to the City for review

More information

APPLICATION FOR BUSINESS LICENSE INCLUDING SALES AND USE TAX AND OCCUPATIONAL PRIVILEGE TAX REGISTRATION

APPLICATION FOR BUSINESS LICENSE INCLUDING SALES AND USE TAX AND OCCUPATIONAL PRIVILEGE TAX REGISTRATION City of Aurora Tax and Licensing 15151 E. Alameda Parkway, Suite 1100 Aurora, CO 80012 (303) 739-7057 www.auroragov.org REGISTRATION/LICENSE FEE: $49.25 PAYABLE TO CITY OF AURORA Special licenses may require

More information

LIQUOR LICENSE APPLICATION - PRE-APPROVAL REVIEW (FORM A)

LIQUOR LICENSE APPLICATION - PRE-APPROVAL REVIEW (FORM A) When completed please mail to: West Fargo City Hall 800 4th AVE E STE 1 West Fargo ND, 58078 If you have any questions, please call: (701)433-5300 LIQUOR LICENSE APPLICATION - PRE-APPROVAL REVIEW (FORM

More information

PRIVATE INVESTIGATOR COMPANY APPLICANT INSTRUCTIONS

PRIVATE INVESTIGATOR COMPANY APPLICANT INSTRUCTIONS COMMONWEALTH OF KENTUCKY KENTUCKY BOARD LICENSURE FOR PRIVATE INVESTIGATORS PO BOX 1360 FRANKFORT KY 40602 (502) 564-3296, Ext. 239 (502) 56696-5230 FAX PRIVATE INVESTIGATOR COMPANY APPLICANT INSTRUCTIONS

More information

APPLICATION FOR LIQUOR LICENSE

APPLICATION FOR LIQUOR LICENSE 700 N. DIVISION STREET MORRIS, ILLINOIS 60450 CITY OF MORRIS Richard P. Kopczick Mayor (815) 942-5438 FAX: (815) 941-5236 APPLICATION FOR LIQUOR LICENSE Morris, Illinois Date: To the Mayor of the City

More information

City of Oakwood, Hall County, Georgia Application for Amusement Arcade/Game MachineLicense

City of Oakwood, Hall County, Georgia Application for Amusement Arcade/Game MachineLicense City of Oakwood, Hall County, Georgia Application for Amusement Arcade/Game MachineLicense License Year: Previous Year: License No.: Issued, Renewed License No. Amusement Arcade Instructions: Every question

More information

CLASS B LIMOUSINE CARRIER CERTIFICATE

CLASS B LIMOUSINE CARRIER CERTIFICATE GEORGIA DEPARTMENT OF PUBLIC SAFETY MCCD REGULATIONS COMPLIANCE P.O. BOX 1456 ATLANTA, GEORGIA 30371 (404) 624-7244 OR (404) 624-7243 FAX: (404) 624-7246 www.gamccd.net APPLICATION FOR CLASS B LIMOUSINE

More information

STATE OF CONNECTICUT INSURANCE DEPARTMENT

STATE OF CONNECTICUT INSURANCE DEPARTMENT STATE OF CONNECTICUT INSURANCE DEPARTMENT Fraud, Licensee Investigations and Compliance Unit P.O. Box 816 Hartford, CT 06142-0816 APPLICATION FOR LIFE SETTLEMENT PROVIDER LICENSE General Instructions:

More information

SELLER TRAINING INTERNET-BASED BRANCH SCHOOL CERTIFICATE APPLICATION FORM ST-401IBB (02/2011)

SELLER TRAINING INTERNET-BASED BRANCH SCHOOL CERTIFICATE APPLICATION FORM ST-401IBB (02/2011) INTERNET-BASED BRANCH SCHOOL CERTIFICATE APPLICATION FORM ST-401IBB (02/2011) REQUIREMENTS: A branch internet-based seller server school certificate is required for each domain that offers a different

More information

Residential Builders New Application

Residential Builders New Application State of Arkansas CONTRACTORS LICENSING BOARD Residential Builders New Application $100.00 Filing Fee - NON-REFUNDABLE MAIL TO: CONTRACTORS LICENSING BOARD 4100 RICHARDS ROAD NORTH LITTLE ROCK, ARKANSAS

More information

SOLICITOR S PERMIT PROCESSING

SOLICITOR S PERMIT PROCESSING SOLICITOR S PERMIT PROCESSING The following procedures must be completed when applying for a Solicitor s Permit: APPLICATION Section I must be completed by the employing wholesaler. All questions on Section

More information

ALL LOAN BROKERS AND ORIGINATORS DOING BUSINESS IN INDIANA FROM: OFFICE OF SECRETARY OF STATE TODD ROKITA, SECURITIES DIVISION

ALL LOAN BROKERS AND ORIGINATORS DOING BUSINESS IN INDIANA FROM: OFFICE OF SECRETARY OF STATE TODD ROKITA, SECURITIES DIVISION MEMORANDUM TO: ALL LOAN BROKERS AND ORIGINATORS DOING BUSINESS IN INDIANA FROM: OFFICE OF SECRETARY OF STATE TODD ROKITA, SECURITIES DIVISION RE: LICENSING AND REGISTRATION REQUIREMENTS FOR LOAN BROKERS

More information

INSTRUCTIONS FOR COMPLETING DBPR ABT 6006 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR CIGAR WHOLESALE DEALER PERMIT

INSTRUCTIONS FOR COMPLETING DBPR ABT 6006 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR CIGAR WHOLESALE DEALER PERMIT INSTRUCTIONS FOR COMPLETING DBPR ABT 6006 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR CIGAR WHOLESALE DEALER PERMIT If you have any questions or need assistance in completing this application,

More information

Cherokee County HOME Rehabilitation Program Eligibility Criteria

Cherokee County HOME Rehabilitation Program Eligibility Criteria Cherokee County HOME Rehabilitation Program Eligibility Criteria Cherokee County has funds available to provide loans for housing rehabilitation repairs to qualified homeowners. This money can be used

More information

RHODE ISLAND DEPARTMENT OF LABOR AND TRAINING DIVISION OF WORKFORCE REGULATION AND SAFETY PROFESSIONAL REGULTION UNIT

RHODE ISLAND DEPARTMENT OF LABOR AND TRAINING DIVISION OF WORKFORCE REGULATION AND SAFETY PROFESSIONAL REGULTION UNIT RHODE ISLAND DEPARTMENT OF LABOR AND TRAINING DIVISION OF WORKFORCE REGULATION AND SAFETY PROFESSIONAL REGULTION UNIT NEW ALARM BUSNIESS LICENSE REQUIERMENTS: Application for Alarm Business License must

More information

MASSAGE THERAPY CERTIFICATE 2016 LICENSE APPLICATION INSTRUCTIONS City of Plymouth 3400 Plymouth Boulevard, Plymouth, MN 55447 763-509-5000

MASSAGE THERAPY CERTIFICATE 2016 LICENSE APPLICATION INSTRUCTIONS City of Plymouth 3400 Plymouth Boulevard, Plymouth, MN 55447 763-509-5000 MASSAGE THERAPY CERTIFICATE 2016 LICENSE APPLICATION INSTRUCTIONS City of Plymouth 3400 Plymouth Boulevard, Plymouth, MN 55447 763-509-5000 The following application forms must be completed, by the individual

More information

Applicant must provide day time phone number on application form.

Applicant must provide day time phone number on application form. INSTRUCTIONS SPECIAL DESIGNATED LICENSE APPLICATION FOR NON PROFIT ORGANIZATIONS OR NONPROFIT PURPOSE ORIGINAL APPLICATION AND 2 COPIES MUST BE FILED WITH CITY CLERK. SERVER TRAINING IS BEING REQUIRED

More information

GEORGIA BOARD OF PHARMACY A Division of the Georgia Department of Community Health 2 Peachtree Street, N.W. 6 th Floor Atlanta, Georgia 30303

GEORGIA BOARD OF PHARMACY A Division of the Georgia Department of Community Health 2 Peachtree Street, N.W. 6 th Floor Atlanta, Georgia 30303 GEORGIA BOARD OF PHARMACY A Division of the Georgia Department of Community Health 2 Peachtree Street, N.W. 6 th Floor Atlanta, Georgia 30303 PHARMACIST APPLICANT INFORMATION SHEET Examination dates are

More information

LICENSING PROCEDURES FOR MANAGING GENERAL AGENTS TO OBTAIN AUTHORITY IN VIRGINIA

LICENSING PROCEDURES FOR MANAGING GENERAL AGENTS TO OBTAIN AUTHORITY IN VIRGINIA LICENSING PROCEDURES FOR MANAGING GENERAL AGENTS TO OBTAIN AUTHORITY IN VIRGINIA October 2005 GENERAL INFORMATION The 1992 Virginia General Assembly passed legislation requiring the licensing of managing

More information

Michael Gayoso, Jr. Office of the County Attorney TH

Michael Gayoso, Jr. Office of the County Attorney TH Michael Gayoso, Jr. Office of the County Attorney TH 11 Judicial District/Crawford County, Kansas DIVERSION PROGRAM -- DRIVING UNDER THE INFLUENCE Pursuant to K.S.A. 22-2906 et seq. the Crawford County

More information

Office of Consumer Protection P. O. Box Helena, MT (406) or (800) TELEMARKETING REGISTRATION APPLICATION

Office of Consumer Protection P. O. Box Helena, MT (406) or (800) TELEMARKETING REGISTRATION APPLICATION Department of Justice Office of Consumer Protection P. O. Box 200151 Helena, MT 59620-0151 (406) 444-4500 or (800) 481-6896 TELEMARKETING REGISTRATION APPLICATION OFFICIAL USE ONLY Registration Number:

More information

REQUEST FOR QUOTATION For MOVING SERVICES FOR CHATHAM COUNTY SUPERIOR COURT AND STATE COURT

REQUEST FOR QUOTATION For MOVING SERVICES FOR CHATHAM COUNTY SUPERIOR COURT AND STATE COURT REQUEST FOR QUOTATION For MOVING SERVICES FOR CHATHAM COUNTY SUPERIOR COURT AND STATE COURT QUOTE NUMBER: 14-0118-3 The Number Must Appear On All Quotations and Related Correspondence. Quotation must be

More information

Hempfield Township Board of Supervisors

Hempfield Township Board of Supervisors Hempfield Township Board of Supervisors 05/05/2015 MASSAGE THERAPIST APPLICATION Attach the following items at the time of application and renewal. Incomplete applications will not be processed or accepted.

More information

5. The location and description of the premises or place of business which is to be operated under such license.

5. The location and description of the premises or place of business which is to be operated under such license. VERGENNES TOWNSHIP, KENT COUNTY, MICHIGAN Ordinance 2004-10 Renamed and Amended June 2007 Formerly Titled Township Beer and Wine License Ordinance Amendments eliminated term beer and wine and replaced

More information

LICENSING PROCEDURES FOR AUTOMOBILE CLUB AGENTS (MOTOR CLUB AGENTS)

LICENSING PROCEDURES FOR AUTOMOBILE CLUB AGENTS (MOTOR CLUB AGENTS) LICENSING PROCEDURES FOR AUTOMOBILE CLUB AGENTS (MOTOR CLUB AGENTS) Requirements for an Automobile Club (Motor Club) Agent License (1) Completed, signed and notarized application (2) $20.00 filing fee

More information

Massage Therapist License Application 12350 W 87 Street Pkwy Phone 913-477-7500 P.O. Box 14888 Fax 913-477-7730 Lenexa, KS 66285-4888 www.lenexa.

Massage Therapist License Application 12350 W 87 Street Pkwy Phone 913-477-7500 P.O. Box 14888 Fax 913-477-7730 Lenexa, KS 66285-4888 www.lenexa. Massage Therapist License Application 12350 W 87 Street Pkwy Phone 913-477-7500 P.O. Box 14888 Fax 913-477-7730 Lenexa, KS 66285-4888 www.lenexa.com NOTE: Any failure to fully or truthfully answer any

More information

The Legal Guide To Establishing A Brewery In Massachusetts

The Legal Guide To Establishing A Brewery In Massachusetts The Legal Guide To Establishing A Brewery In Massachusetts Law Offices of John P. Connell, P.C 112 Water Street, Suite 201 Boston, MA 02109 www.connelllawoffices.com @ConnellLaw The Application Process

More information

GEORGIA DEPARTMENT OF PUBLIC SAFETY MCCD, REGULATIONS COMPLIANCE P.O. Box 1456 ATLANTA, GEORGIA 30371 (404) 624-7244 OR (404) 624-7243 www.gamccd.

GEORGIA DEPARTMENT OF PUBLIC SAFETY MCCD, REGULATIONS COMPLIANCE P.O. Box 1456 ATLANTA, GEORGIA 30371 (404) 624-7244 OR (404) 624-7243 www.gamccd. GEORGIA DEPARTMENT OF PUBLIC SAFETY MCCD, REGULATIONS COMPLIANCE P.O. Box 1456 ATLANTA, GEORGIA 30371 (404) 624-7244 OR (404) 624-7243 www.gamccd.net APPLICATION FOR A PASSENGER PERMIT (CHARTER OPERATIONS)

More information

GUIDE TO SECOND HAND MOTOR VEHICLE DEALER LICENSES

GUIDE TO SECOND HAND MOTOR VEHICLE DEALER LICENSES GUIDE TO SECOND HAND MOTOR VEHICLE DEALER LICENSES A license must be obtained before operating a used car motor vehicle dealership. Licensure is valid from the date of the license through December 31.

More information

CHAPTER 7 Alcohol Beverage Control

CHAPTER 7 Alcohol Beverage Control CHAPTER 7 Alcohol Beverage Control Section 7.1 Operation without permit prohibited; definitions Section 7.2 Application for permit Section 7.3 Submission of application Section 7.4 Qualification of applicants

More information

30 Day Limited Permits for Professional Engineers and Land Surveyors

30 Day Limited Permits for Professional Engineers and Land Surveyors THE STATE EDUCATION DEPARTMENT / THE UNIVERSITY OF THE STATE OF NEW YORK / ALBANY, NY 12234 Office of the Professions, State Board for Engineering and Land Surveying PHONE: 518-474-3817 ext. 140 FAX: 518-473-6282

More information

RETURN TO ALCOHOLIC BEVERAGE CONTROL PERMIT DEPARTMENT P.O. BOX 540 MADISON, MS 39130-0540

RETURN TO ALCOHOLIC BEVERAGE CONTROL PERMIT DEPARTMENT P.O. BOX 540 MADISON, MS 39130-0540 APPLICATION, CHANGE IN LOCATION OF ABC PERMITTED BUSINESS RETURN TO ALCOHOLIC BEVERAGE CONTROL PERMIT DEPARTMENT P.O. BOX 540 MADISON, MS 39130-0540 APPLICATION INSTRUCTIONS Please read these instructions

More information

Business Trade Name Business Address. City Zip Code County _Beltrami_ Township Business Ph

Business Trade Name Business Address. City Zip Code County _Beltrami_ Township Business Ph Minnesota Department of Public Safety Alcohol and Gambling Enforcement Division (AGED) 444 Cedar Street, Suite 133, St. Paul, MN 55101-5133 Telephone 651-201-7503 Fax 651-297-5259 TTY 651-282-6555 Certification

More information

APPLICATION FOR PHARMACY TECHNICIAN REGISTRATION Information for Individuals who desire to register as a Pharmacy Technician

APPLICATION FOR PHARMACY TECHNICIAN REGISTRATION Information for Individuals who desire to register as a Pharmacy Technician NAME 9906/001 Application $75.00 9906/006 Regulatory $10.00 STATE OF TENNESSEE DEPARTMENT OF HEALTH DIVISION OF HEALTH LICENSURE AND REGULATION www.tennessee.gov/health APPLICATION FOR PHARMACY TECHNICIAN

More information

PRIVATE INVESTIGATOR APPLICANT INSTRUCTIONS

PRIVATE INVESTIGATOR APPLICANT INSTRUCTIONS COMMONWEALTH OF KENTUCKY KENTUCKY BOARD OF LICENSURE FOR PRIVATE INVESTIGATORS PO BOX 1360 FRANKFORT KY 40602-1360 (502) 564-3296, ext. 223 (502) 564-4818 FAX PRIVATE INVESTIGATOR APPLICANT INSTRUCTIONS

More information

DOUGLAS COUNTY DISTRICT ATTORNEY S OFFICE Diversion Program Guidelines Charles E. Branson, District Attorney Updated May 8, 2015

DOUGLAS COUNTY DISTRICT ATTORNEY S OFFICE Diversion Program Guidelines Charles E. Branson, District Attorney Updated May 8, 2015 DOUGLAS COUNTY DISTRICT ATTORNEY S OFFICE Diversion Program Guidelines Charles E. Branson, District Attorney Updated May 8, 2015 CRIMINAL DIVERSION APPLICATION The Douglas County District Attorney has

More information

CHARTER SIGHTSEEING LICENSE APPLICATION

CHARTER SIGHTSEEING LICENSE APPLICATION Rahm Emanuel Mayor City of Chicago Department of Business Affairs and Consumer Protection Public Vehicle Operations Division 2350 West Ogden Avenue, 1st Floor Chicago, Illinois 60608 (312) 746-4200 (312)

More information

LICENSING PROCEDURES FOR LIFE SETTLEMENT BROKERS AND PROVIDERS

LICENSING PROCEDURES FOR LIFE SETTLEMENT BROKERS AND PROVIDERS Fax: (615) 532-2862 STATE OF TENNESSEE DEPARTMENT OF COMMERCE AND INSURANCE Insurance Division Agent Licensing 500 James Robertson Parkway Nashville, TN 37243-1134 615 741-2693 ce.agent.licensing@state.tn.us

More information

HOW TO FILE A PETITION TO EXPUNGE JUVENILE OFFENSES

HOW TO FILE A PETITION TO EXPUNGE JUVENILE OFFENSES HOW TO FILE A PETITION TO EXPUNGE JUVENILE OFFENSES Disclaimer Neither the staff in Court Administration nor the staff in any Court office will be able to give you legal advice or help you fill out/complete

More information

LICENSING PROCEDURES FOR VIATICAL SETTLEMENT BROKERS AND PROVIDERS

LICENSING PROCEDURES FOR VIATICAL SETTLEMENT BROKERS AND PROVIDERS Fax: (615) 532-2862 STATE OF TENNESSEE DEPARTMENT OF COMMERCE AND INSURANCE Insurance Division Agent Licensing 500 James Robertson Parkway Nashville, TN 37243-1134 615 741-2693 ce.agent.licensing@tn.gov

More information

Sec. 90-27. Certificates of use.

Sec. 90-27. Certificates of use. Sec. 90-27. Certificates of use. (1) It is hereby deemed unlawful for any person to open or operate any business and/or occupy any structure within the town limits for the privilege of engaging in any

More information

APPLICATION FOR ASSIGNMENT, SALE, TRANSFER OR CHANGE OF OWNERSHIP STRUCTURE OF EXISTING PRIVATE CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY

APPLICATION FOR ASSIGNMENT, SALE, TRANSFER OR CHANGE OF OWNERSHIP STRUCTURE OF EXISTING PRIVATE CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY OFFICE OF AMBULANCE REGULATION COORDINATION 140 WEST FLAGLER STREET SUITE 904 MIAMI, FLORIDA 33130-1561 Tel: (305) 375-5801 Fax: (305) 372-6321 E-mail: consumer@miamidade.gov APPLICATION FOR ASSIGNMENT,

More information

Kentucky Motor Vehicle Commission SALESPERSON LICENSE APPLICATION IMPORTANT NOTICE REGARDING ALL SALES PERSONNEL

Kentucky Motor Vehicle Commission SALESPERSON LICENSE APPLICATION IMPORTANT NOTICE REGARDING ALL SALES PERSONNEL IMPORTANT NOTICE REGARDING ALL SALES PERSONNEL All persons employed by a dealership in a sales capacity, even if on a temporary basis, and those individuals identified in 605 KAR 1:050 Section 5 must be

More information

THE ATC FORM MUST BE COMPLETED FULLY

THE ATC FORM MUST BE COMPLETED FULLY GENERAL INFORMATION FOR PREPARING AN APPLICATION FOR TAX CERTIFICATE (ATC) FORM CITY OF BIRMINGHAM, ALABAMA FINANCE DEPARTMENT - TAX AND LICENSE ADMINISTRATION DIVISION 710 NORTH 20TH STREET, ROOM TL-100

More information

DEPARTMENT OF HEALTH. APPLICATION FOR LIMITED LICENSURE and Instructions

DEPARTMENT OF HEALTH. APPLICATION FOR LIMITED LICENSURE and Instructions DEPARTMENT OF HEALTH BOARD OF CLINICAL SOCIAL WORK, MARRIAGE AND FAMILY THERAPY AND MENTAL HEALTH COUNSELING APPLICATION FOR LIMITED LICENSURE and Instructions APPLICATION FOR LIMITED LICENSURE INSTRUCTIONS

More information

PROCESS SERVER CERTIFICATION CHECKLIST. Signed and Dated Application for certified process server. Signed and Notarized Release of information

PROCESS SERVER CERTIFICATION CHECKLIST. Signed and Dated Application for certified process server. Signed and Notarized Release of information PROCESS SERVER CERTIFICATION CHECKLIST Enclosed please find a copy of Amended Administrative Order 02-08 and an application packet. The completed application packet and all items on the checklist are to

More information

INSTRUCTIONS FOR COMPLETING AN APPLICATION FOR A LICENSE TO OPERATE A DRUG ABUSE TREATMENT AND EDUCATION PROGRAM

INSTRUCTIONS FOR COMPLETING AN APPLICATION FOR A LICENSE TO OPERATE A DRUG ABUSE TREATMENT AND EDUCATION PROGRAM INSTRUCTIONS FOR COMPLETING AN APPLICATION FOR A LICENSE TO OPERATE A DRUG ABUSE TREATMENT AND EDUCATION PROGRAM No governing body shall operate a drug abuse treatment and education program in the state

More information

Application for Registration or Renewal of Athlete Agent

Application for Registration or Renewal of Athlete Agent 11 F0091 OFFICE OF THE MISSISSIPPI SECRETARY OF STATE Post Office Box 136, Jackson, MS 39205-0136 (601)359-9055 Application for Registration or Renewal of Athlete Agent A Certificate of Registration or

More information

NOTICE TO ALL APPLICANTS FOR CONTRACTOR'S OCCUPATIONAL REGISTRATION

NOTICE TO ALL APPLICANTS FOR CONTRACTOR'S OCCUPATIONAL REGISTRATION NOTICE TO ALL APPLICANTS FOR CONTRACTOR'S OCCUPATIONAL REGISTRATION Attached is an application packet for a contractor's occupational registration. The following information is required: Completed Application

More information