KANSAS DEPARTMENT OF REVENUE ALCOHOLIC BEVERAGE CONTROL DIVISION DO NOT WRITE IN THIS BOX VALIDATED AMOUNTS LIC. FEE CASHIER REG. FEE APPLICATION FOR LIQUOR LICENSURE LICENSED PREMISES (Business Location) MAILING ADDRESS Business Name Name Address Address City State Zip Code City State Phone Number Phone Number License No. Zip Code Expiration Date: (Renewal Only) 1. LICENSE TYPE: (Check the box for the type of license for which you are applying) Class A (Fraternal/Veterans) - $250 Class A - Social (Over 500 members) - $1,000 Drinking Establishment (DE) - $1,000 Hotel/Caterer - $3,500 Hotel - $3,000 Farm Winery - $250 Farm Winery Outlet – $50 Manufacturer (Check one below) Alcohol & Spirits - $2,500 Wine - $500 Beer – (See Daily Barrel Capacity) 1 – 100 = $200 100 – 150 = $400 150 – 200 = $700 200 – 300 = $1,000 300 – 400 = $1,300 400 – 500 = $1,400 500 or more = $1,600 2. TYPE OF OWNERSHIP: Individual Corporation Partnership LLC LLP LP Class A - Social (500 members or less) - $500 Class B - $1,000 Reciprocal: Y or N Caterer - $500 DE/Caterer - $1,500 Retailer - $250 Microbrewery - $250 Microbrewery Pkg & Warehousing – $100 Distributor - $1,000 (Check one below Spirits Wine Beer Non-Beverage User (Check one below) Class 1 - $10/up to 100 Gallons Class 2 - $50/up to 1000 Gallons Class 3 - $100/up to 5000 Gallons Class 4 - $200/up to 10,000 Gallons Class 5 - $500/over 10,000 Gallons C Corporation General Partnership 3. APPLICATION PROCESSING (REGISTRATION FEE): New - $50 Renewal - $10 License fee, Registration fee and tax bond must be submitted, as provided under K.S.A. 41-317, in the form of a certified or cashier’s check from a bank within the State, United States Postal Money Order or cash in the full amount of the fees. All fees are to be made payable to: U Director, Alcoholic Beverage Control Customer Relations/Licensing 915 SW Harrison Street Topeka, KS 66625-2073 Phone (785) 368-8222 or Fax (785) 291-3968 4. TAX BOND AMOUNTS: • • • • • Manufacturer - $25,000 • Beer/Wine Distributor - $5,000 • Microbrewery/Farm Winery - $2,000 Retailer - $2,000 On-Premise - $1,000 Minimum (Clubs & DE’s) ABC-252 (Rev. 7/05) Spirits Distributor - $15,000 Non-Beverage Users: Class 1 - $200 Class 4 - $5,000 Class 2 - $500 Class 5 - $10,000 Class 3 - $1,000 KEEP A COPY FOR YOUR RECORDS American LegalNet, Inc. www.FormsWorkflow.com