STATE OF NEW YORK LIQUOR AUTHORITY FEES: APPLICATION FOR MICROBREWERY LICENSE Annual Fee: $ 320.00 Filing Fee: Cyclical Billing: Section 55b: TOTAL FEE: $ 400.00 $ 80.00 $ 100.00 $ 900.00 Effective January 1, 1994, Section 56, subdivision 1 of the Alcohol Beverage Law as amended, provides for a new annual beer brewer's license. The license period begins on the date of issuance and expires one year from that date. The applicant is eligible for this license if production for the licensed period does not exceed 60,000 barrels. A $1,000 bond is required, issued by a surety company authorized to execute such bonds in N.Y. State. At the time of renewal, or upon termination of the license, the licensee must submit certified production records for the prior licensed period and an affidavit stating that production did not exceed 60,000 barrels. If production exceeds 60,000 barrels during the license period, the licensee must pay the $4,000 fee established under Section 56. This license permits the licensee to sell from the licensed premises to licensed wholesalers, retailers and permittees in this state, and to sell or deliver such beer to persons outside the state pursuant to the laws of the place of such sale or delivery (Section 56, subdivision 1). This is not a retail license. If the licensee intends to traffic in alcoholic beverages in a manner other than defined in Section 56, subdivision 1, the licensee is required to file a separate application(s), appropriate to that class and to pay the appropriate fees, to comply with the provisions of the ABC Law relative to licenses to sell beer, wine, or liquor at retail for consumption on or off premises. Failure to do so can result in disciplinary action including suspension, cancellation or revocation of this license. YOU ARE REQUIRED TO COMPLETE THE ALCOHOLIC BEVERAGE CONTROL RETAIL APPLICATION IF FILING FOR AN ON-PREMISE LIQUOR LICENSE WITH THE MICROBREWERY LICENSE. YOU ARE REQUIRED TO COMPLETE THE APPLICATION FOR ALCOHOLIC BEVERAGE CONTROL MANUFACTURER/WHOLESALE APPLICATION IF FILING FOR MICROBREWER LICENSE ONLY. APPLICANT'S NAME: ADDRESS OF PREMISES: CITY, TOWN OR VILLAGE AND COUNTY: ZIP CODE: TELEPHONE NO: I certify that I intend to produce less than 60,000 barrels of beer during the licensed period and will be required to pay the $3,125 established under Section 56 of the ABC Law if production exceeds that amount. Signature of Applicant Title Dated DO NOT WRITE BELOW THIS LINE -- FOR OFFICIAL USE ONLY ================================================================================================ LICENSE DIVISION RECOMMENDATION APPROVED DISAPPROVED NAME: TITLE: DATE: FORM: 101 MI (revised 03/2005) American LegalNet, Inc. www.FormsWorkflow.com