INSTRUCTIONS FOR COMPLETING DBPR ABT– 6020 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR COMMON CARRIER LICENSE Application begins on page 3 If you have any questions or need assistance in completing this application, please contact the Department of Business and Professional Regulation at (850) 488-8284. Please send your completed application and required fee(s) to: Department of Business and Professional Regulation 1940 North Monroe Street Tallahassee, FL 32399-1021 GENERAL INSTRUCTIONS AND APPLICATION REQUIREMENTS Please complete all information. Incomplete applications will be returned. All questions are applicable and must be answered fully and truthfully. This application is taken under oath. Persons filing false applications or information may be prosecuted and the application denied. You must provide an original copy of the application and a copy of all supporting documentation. All signatures must be original. Corporate and Limited Partnership Registration All corporations, domestic or foreign, general partnerships, limited liability corporations, and limited partnerships are required to be registered with the Florida Secretary of State, Division of Corporations. If you have not already registered, you will need to contact the Department of State at (850) 488-9000 for further information. Your application cannot be accepted without this registration. License Year The license year is October 1 through September 30. The full year fee applies to all licenses issued between October 1 and March 31. Fees are prorated to a half-year for licenses issued on or after April 1. Fees Series X: This license series applies to operators of steamship lines, buses and bus lines, airplanes and airlines engaged in interstate or foreign commerce or plying between fixed terminals and upon fixed schedules in Florida. The Master License fee for this Series is $1,100 ($550 if application is submitted after April 1). Series IX: This license series applies to operators of railroad or sleeping cars in Florida. The Master License fee for this series is $2,500 ($1,250 if application is submitted after April 1). The application must be accompanied by a check in the amount of the fee for the license requested. Make checks payable to the Department of Business and Professional Regulation. 1 American LegalNet, Inc. www.FormsWorkflow.com APPLICATION CHECKLIST Select the appropriate transaction below and comply with the corresponding application requirements. TRANSACTION Initial License for Common Carrier, Series X Initial License for Common Carrier, Series IX APPLICATION REQUIREMENTS ‰ Pay $1,100 Master License fee if applying for licensure between OCTOBER 1 and MARCH 31 OR; Pay $550 Master License fee if applying for licensure between APRIL 1 and SEPTEMBER 30. Make check payable to the Department of Business and Professional Regulation. ‰ Complete DBPR ABT-6020 Division of Alcoholic Beverages and Tobacco Application for Common Carrier License ‰ Submit copy of flight itinerary ‰ Pay $2,500 Master License fee if applying for licensure between OCTOBER 1 and MARCH 31 OR; Pay $1,250 Master License fee if applying between APRIL 1 and SEPTEMBER 30. Make check payable to the Department of Business and Professional Regulation. ‰ Complete DBPR ABT-6020 Division of Alcoholic Beverages and Tobacco Application for Common Carrier License 2 American LegalNet, Inc. www.FormsWorkflow.com DBPR ABT-6020– Division of Alcoholic Beverages and Tobacco Application for Common Carrier License STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 1940 North Monroe Street Tallahassee, FL 32399-0783 If you have any questions or need assistance in completing this application, please contact the Department of Business and Professional Regulation at (850) 488-8284. Please send your completed application and required fee(s) to: Department of Business and Professional Regulation 1940 North Monroe Street Tallahassee, FL 32399-1021 SECTION 1 - CHECK TRANSACTION REQUESTED Transaction Type: ‰ New License for Common Carrier Series X ‰ New License for Common Carrier Series IX SECTION 2 - APPLICANT INFORMATION Full Name of Applicant Business Name Mailing Address City State Zip Code Name of Florida Airport/Terminal/Port City County Contact Person Dept. Phone Number 1. If you operate buses, steamships or airplanes in Florida, are they operated between fixed terminals and upon fixed schedules? ‰ Yes ‰ No 2. Is this applicant a corporation? ‰ Yes ‰ No If yes, please list your Florida Corporate Number:__________________________________________ 3 American LegalNet, Inc. www.FormsWorkflow.com SECTION 3 - CORPORATE FELONY CONVICTION Trade Name (D/B/A) Has the applicant corporation been convicted of a felony in this state, any other state, or by the United States in the last 15 years? ‰ Yes ‰ No If the answer is “Yes,” please list all details including the date of conviction, the crime for which the corporation was convicted, and the city, county, state and court where the conviction took place. 4 American LegalNet, Inc. www.FormsWorkflow.com SECTION 4 - AFFIDAVIT OF APPLICANT NOTARIZATION REQUIRED Trade Name (D/B/A) “I, the undersigned individually, or if a corporation for itself, its officers and directors, hereby swear or affirm that I am duly authorized to make the foregoing application and agree that the steamships, buses or airplanes in addition to the designated central location, may be inspected and searched during business hours or at any time business is being conducted on the premises without a search warrant by officers of the Division of Alcoholic Beverages and Tobacco, the sheriff, his deputies, and police officers for the purposes of determining compliance with the beverage laws.” “It is understood that any license issued pursuant to this application authorizes the operators of railroads or sleeping cars, steamships and steamship lines, buses and bus lines, airplanes and airlines, to sell the alcoholic beverages defined in the beverage law to bona fide passengers only and for consumption on the licensed premises only. It is also understood that such sales are permitted while such passenger train, steamships, buses, and airplanes are in transit; but such sales are not permitted on airplanes while they are in airports.” “I swear under oath or affirmation under penalty or perjury as provided for in Sections 559.791, 562.45, and 837.06, Florida Statutes, that the foregoing information is true and that all of the above listed persons or entities meet the qualifications necessary to hold an alcoholic beverage license.” STATE OF___________________ _________________________________________________ APPLICANT SIGNATURE COUNTY OF_________________ _________________________________________________ APPLICANT SIGNATURE The foregoing was ( ) Sworn to and Subscribed OR ( ) Acknowledged Before me this _______Day of______________, 20_____, By ____________________________________________ who is ( ) personally known to me OR ( ) who produced ___________________________________________as identification. ________________________________________________ Commission Expires: ___________________ Notary Public 5 American LegalNet, Inc. www.FormsWorkflow.com