plcb-21 4/12 commonwealth of pennsylvania pennsylvania liquor control board APPLICATION FOR TRANSFER OF LICENSE AND PERMIT (see instructions on reverse) bureau of licensing i hereby agree to the transfer of my license and permits, if any, to the applicant named in block 6 and to the premises shown in block 8 and 9. I guarantee to make no other attempt to transfer said license and permits until this application has been definitely acted upon. 1. name of licensee 2. trade name (if any) 3. address of premises 4. name of municipality 5. (street, rural route, p.o. box no.) (post office) INFORMATION AS TO PRESENT LICENSEE AND ADDRESS OF LICENSED PREMISES lid license no. amusement permit yes no (state) (Zip) type of municipality city boro twp. inc. town county RESOLUTION at a regular or special meeting held on and/or (name/title) , 20 by the licensed is/are corporation, it was resolved that said application be filed with the Pennsylvania Liquor Control Board, and that (name/title) hereby authorized to execute said application, and any other papers required by the Board. INFORMATION FOR APPLICANT AND ADDRESS OF PREMISES TO BE LICENSED 6. name of applicant 7. trade name (if any) 8. address of premises 9. name of municipality (street, rural route, p.o. box no.) (post office) (state) (Zip) is amusement permit to be transferred? yes no type of municipality city boro twp. inc. town county I swear or affirm, subject to the penalties provided by 18 Pa. C.S. §4904 and 47 P.S. §4-403(h) and/or §4-436(j) and/or §5-504(b) and/or §7-704, that the foregoing answers and statements provided herein are true and complete to the best of my knowledge and belief. signature of present licensee print name of person signing home address of present licensee title date of execution phone This application for transfer must be accompanied by the following supporting papers and requisite fee(s): a. application and other supporting documents as instructed on the accompanying application for type of license and permits desired. b. check or money order made payable to the PLCB or the Commonwealth of Pennsylvania for license transfer fee of $650 for person to person, or $550 for place to place, or $700 for both person to person and place to place. this fee is not refundable. c. additional fee of $10.00 if the current amusement permit is to be transferred. d. if an inter-municipal transfer of a retail license, written approval from the governing body of the receiving municipality if the retail municipal quota is met or exceeded. E. If the transfer is for a retail liquor or retail malt beverage dispenser license from a city of the 1st class to a county of the 2nd class A or 3rd class designated as a Mixed-Use Town Center Development Project, the following is required: 1. municipal approval as described in "d." 2. resolution or ordinance stating the municipality has designated the location a mixed-use town center development project. 3. $50,000 surcharge fee along with the transfer fee as described in "b." 4. Intra-County Affirmation stating the applicant has exhausted reasonable means for obtaining a suitable license within the county. 5. Affidavit from a real estate agent, license broker or other similar professional attesting to the unavailability of a liquor license at a relative market price. DO NOT WRITE BELOW THIS LINE lid pm co/mncp code _ _ - _ _ _ Zip _ _ _ _ _ - _ _ _ _ American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS 1. General A. This form is used for transfer of the licenses listed below from person to person, place to place, or both, subject to the specified limitations as to municipality or county: Retail liquor and malt beverage licenses within the same municipality or from municipality to municipality within the same county (inter-municipal). Retail liquor and malt beverage licenses from a First Class city to a Second Class A or Third Class county designated as a mixed-use town center development project. Liquor importers, sacramental wine, brewery, alternate brewers, distilleries, wineries, limited wineries, bonded warehouses, bailees-for-hire and transporter-for-hire. distributor and importing distributor licenses within the same county. b. c. this form is also used for the addition of any new partner. it is not to be used for the dissolution of a partnership, by voluntary retirement or death of one or more of the partners, change in trade name only or a change in address not resulting from a change in location of the premises involved (for instance, by post Office or municipality redesignation). For any of these purposes, use Form PLCB-959, Application for Correction to License, permit or agent's registration. 2. 3. Filing of Application - Applications for transfer of licenses may be filed at any time, but when filed within 30 days of the expiration date of the license term the transfer shall apply to the renewal license only, except in case of death. Place to Place Transfer - in case a licensee desires to move the place of business from one address to another, the licensee must produce documentary evidence of legal use of the new premises and equipment. If the transfer involves a retail license the premises must be ready for operation as a restaurant, eating place or hotel. no alcoholic beverages shall be sold at the new location until the transfer has received formal board approval. if the transfer involves a license of a type other than retail the new premises must comply with statutory requirements but approval of the transfer by the Board must be obtained before the business is operated at the new address. Person to Person Transfers - When an application is filed for the transfer of a license from one person to another in the same premises, there shall be exhibited to the board or its representatives, an agreement covering the sale of the licensed business and documentary evidence that the transferee has legal right to occupy the premises. the entire purchase price of the licensed business, either in the form of cash or legal obligation as security for the purchase price, shall be placed in escrow with an attorney or financial institution to be paid to the original licensee upon approval of the transfer by the board. since the license and ownership of the business shall not pass to the transferee until the board has approved the transfer, the original licensee may continue to operate the licensed business until formal approval of the transfer has been given. however, if the original