Application For Beer Wine Permit (For Benevolent, Charitable And Public Purpose Events) Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Application For Beer Wine Permit (For Benevolent, Charitable And Public Purpose Events) Form. This is a Idaho form and can be use in State Police Statewide.
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Tags: Application For Beer Wine Permit (For Benevolent, Charitable And Public Purpose Events), Idaho Statewide, State Police
Idaho State Police
ALCOHOL BEVERAGE CONTROL
P.O. Box 700
Meridian, ID 83680-0700
(208) 884-7060
APPLICATION FOR BEER/WINE PERMIT
□ Beer Permit ($20) □ Wine Permit ($20) □ Both Beer and Wine Permit ($40) (Check one)
Applicant Name: _______________________________________________________ State or Federal Tax ID #_____________________
Mailing Address: _________________________________________________________________________________________________
(Address)
(City)
(State)
(Zip Code)
Dates of event: ________________________________________________(Not to Exceed 3 Days) Hours of Event: ___________________
(Please include a.m. or p.m.)
Location of event: _________________________________________________________________________________________________
(Name)
(Address)
(City)
Name of Event: ____________________________________________________________________________________________________
Is the location of the event inside city limits?
Yes_________
No_________
Purpose: _________________________________________________________________________________________________________
Sponsors: ________________________________________________________________________________________________________
Proceeds will be donated to: __________________________________________________________________________________________
PROVIDERS OF BEER
BRAND OF BEER
PROVIDERS OF WINE
BRAND OF WINE
Retailer Designated to Receive, Store, Dispense Beer or Wine: ______________________________________________________________
I HEREBY CERTIFY THAT THE APPLICANT LISTED ABOVE IS NOT OTHERWISE LICNESED IN THE STAE OF IDAHO TO
SELL ALCOHOLIC BEVERAGES AND THE PROCEEDS FROM THIS EVENT WILL BE DONATED FOR BENEVOLENT,
CHARITABLE, OR PUBLIC PURPOSES.
Applicant Signature_____________________________ Title ______________________ Date_____________________________________
Phone Number_____________________________________________________________________________________________________
Subscribed and sworn to this _______________________________________day of _________________________________, 20_________
__________________________________________________
Notary Public
Residing at_____________________________________________________
Commission Expires______________________________________________
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