KANSAS DEPARTMENT OF REVENUE ALCOHOLIC BEVERAGE CONTROL DIVISION 915 SW HARRISON TOPEKA, KANSAS 66625-3512 Winery Shipping Permit Application and Agreement Instructions COMPLETING THE WINERY SHIPPING PERMIT APPLICATION AND AGREEMENT: 1. Permit Type. a. Small Wine Shipping Permit. Check this box if you produce less than 100,000 gallons of wine annually. b. Large Wine Shipping Permit. Check this box if you produce more than 100,000 gallons of wine annually. 2. Application Type. a. New Permit. Check the “New Permit” box if you are applying for a Winery Shipping Permit. b. Renew Permit. Check the “Renew Permit” box to renew your current Winery Shipping Permit. 3. Complete, sign and date the Winery Shipping Permit Application and Agreement form, print your name and title. 4. Make a copy of the completed Winery Shipping Permit Application and Agreement. Retain the copy for your records. This will serve as your permit. COMPLETING THE WINERY SHIPPING PERMIT FEE VOUCHER: 1. Complete the Winery Shipping Permit Fee Voucher attached below. a. New Permit. Check the “New Wine Shipping Permit Fee Voucher” box, enter the name as it appears on the Wine Shipping Permit Application and Agreement and the date completed. b. Renew Permit: Check the “Wine Shipping Permit Renewal” box, enter your Winery Shipping Permit Name, the date completed and your Winery Shipping Permit Number. c. Out-of-State Wine Manufacturer’s License Attached. Check this box if you are an out-of-state applicant. You are required to attach a true copy of your current beverage license authorizing the manufacture of wine in your state. This is required for new permits and permit renewals. 2. Make your check payable to the “Kansas Department of Revenue” for the appropriate amount ($50 for a new permit and $10 for a permit renewal) and attach it to the Winery Shipping Permit Voucher below. APPLICATION CHECK LIST: To expedite the application process, ensure you have submitted the following information to the Kansas Department of Revenue, Alcoholic Beverage Control at the address listed above. 1. The original signed and completed Winery Shipping Permit Application and Agreement. 2. The completed Winery Shipping Permit Voucher. 3. The appropriate Winery Shipping Permit fee ($50 for a new permit and $10 for a permit renewal). 4. If you are an out-of-state applicant, attach a true copy of your current beverage license authorizing the manufacture of wine in your state. APPROVED KANSAS WINERY SHIPPING PERMITS: You will receive e-mail notification from the ABC that your new Winery Shipping Permit has been approved. All approved Winery Shipping Permits are posted to the ABC Active Liquor Licensee Database on the ABC website. Go to this link to view your Winery Shipping Permit. https://www.kdor.org/abc/licensee/ To obtain updated information and reporting forms, visit the Direct Wine Shipment page on our website. Go to: http://www.ksrevenue.org/abcdirwinepermit.htm CONTACT INFORMATION: Direct your questions to the Marketing Unit at 785-296-7015 or e-mail ABC_Marketing_Unit@kdor.state.ks.us Detach and Return with Payment KANSAS ALCOHOLIC BEVERAGE CONTROL DIVISION Winery Shipping Permit Fee Voucher Winery Shipping Permit Name: __________________________________________ Date: ____________ Winery Shipping Permit Number: __ __ - __ __ __ - __ __ __ __ - __ __ (Renewals Only) New Winery Shipping Permit - $50.00 Fee Enclosed (CLPR) Winery Shipping Permit Renewal - $10.00 Fee Enclosed (CLPR) Out-of-State Wine Manufacturer’s License Attached (Required) ABC-267 (Rev. 1.14.09) American LegalNet, Inc. www.FormsWorkflow.com KANSAS DEPARTMENT OF REVENUE ALCOHOLIC BEVERAGE CONTROL DIVISION 915 SW HARRISON TOPEKA, KANSAS 66625-3512 WINERY SHIPPING PERMIT APPLICATION AND AGREEMENT Permit Type (check one): Small Winery Shipping Permit (less than 100,000 gallons produced annually) Large Winery Shipping Permit (more than 100,000 gallons produced annually) Application Type (check one): New Permit Renew Permit _________________________________________________________________________________ Permit Number (Assigned by ABC) FEIN _________________________________________________________________________________ Winery Name _________________________________________________________________________________ Address City State Zip _________________________________________________________________________________ Phone Fax Number _________________________________________________________________________________ Contact Person E-mail Address _________________________________________________________________________________ Compliance Agency (If Applicable) Phone _________________________________________________________________________________ Address City State Zip The above named wine manufacturer does hereby make application for a Winery Shipping Permit to sell wine ordered by consumers. In making this application, the above named wine manufacturer agrees that: a. b. c. d. e. f. g. h. i. j. It will not ship, sell, attempt to sell or deliver any wine to a person under 21 years of age and the wine must be for the consumer’s personal use and not for resale; Out-of-state Winery Shipping Permitees will collect the purchase price and all shipping costs from Kansas consumers prior to shipment; In-state Winery Shipping Permitees will collect the purchase price and shipping costs from consumers as well as comply with the applicable laws of the jurisdiction to which the wine is shipped; Out-of-state Small Winery Shipping Permitees will ship the wine in the original unopened container, utilizing the Kansas Winery Shipping Document (ABC-189), to a licensed Kansas Retail Liquor Store designated by the purchaser; Large Winery Shipping Permitees will ship the wine in the original unopened container, utilizing the Winery Shipping Permit document (ABC-189), to a licensed Kansas Wine Distributor for delivery to the licensed Kansas Retail Liquor Store designated by the purchaser; th Out-of-state Winery Shipping Permitees will report to the director, by the 15 of January, the total wine sold and shipped during the preceding calendar year utilizing the Winery Shipping Annual Report of Sales to Kansas Consumers (ABC-270); and, will remit to the director, by the 15th of January, all gallonage taxes collected from sales to consumers in the State of Kansas during the preceding calendar year utilizing the Winery Shipping Annual Gallonage Tax Return (ABC-268); In-state Winery Shipping Permitees will report to the director, by the 15th of each month utilizing the Kansas Farm Winery Monthly Report of Sales (ABC-262), the total wine sold and shipped during the preceding month; and, will remit to the director, by the 25th of the following month, all liquor enforcement taxes collected for wine sales to consumers during the preceding month utilizing the Winery Shipment Enforcement Tax Return – Farm Winery (ABC-187); Out-of-state Winery Shipping Permitees will allow the director to perform an audit; Out-of-state Winery Shipping Permitees hereby appoints the Secretary of the State of Kansas as its resident agent and representative authorized to accept service of any notice or order and that all such acts by the Secretary of State shall be fully binding upon it; It will abide by all the provisions of the Kansas Liquor Control Act and the Rules and Regulations promulgated thereunder. ________________________________________ ________________________________________ Authorized Signature Date ________________________________________ ________________________________________ Printed Name Printed Title FOR OFFICE USE ONLY: $50 New Permit Fee Received Date ____________ $10 Renewal Fee Received Date ______________ Completed by:____________ Date: ______________ New Permit Approved Date ______________ Expires June 30, 20_______ Permit Renewed From July 1, 20________ to June 30, 20___________ MAKE A COPY FOR YOUR RECORDS You will NOT receive a permit or certificate. Your copy will serve as your permit. ABC-267 (Rev. 1.14.09) American LegalNet, Inc. www.FormsWorkflow.com