Bureau of Alcoholic Beverages Division of Liquor Licensing & Enforcement 8 State House Station Augusta, ME 04333-0008 Tel: (207) 624-7220 Fax: (207) 287-3434 Email inquiries: MaineLiquor@Maine.gov Off Premise Retailer Disclosure of Lessee on the Premise I, ______________________________________ d/b/a ________________________________________ (Name) (Premise Name) in __________________________________, Maine, hereby advise that the Division of a lessee conducting business on my licensed premise and has not been disclosed as an applicant for this license: Name of Lessee: ___________________________ d/b/a ______________________________________ Type of Business: _____________________ Description of Area Leased: _______________________ Diagram of area must be provided with this form. It is agreed in accordance with Division rule 3.6 that the lessee will not possess or sell alcoholic beverages and will allow inspection by the Division of Liquor Licensing & Inspection. Lessee-Signature: __________________________________ Date: ______________________________ Licensee-Signature: _________________________________ Date: ______________________________ RULE 3.6: Not withstanding other provisions of law to the contrary, an applicant for off-premise retail sales need not disclose the identity of a sub-lessee occupying a portion of the licensed premises under the following circumstances: A. B. C. D. The sub-lessee is prohibited, both by Maine law and the applicant, from selling, possessing, transporting otherwise controlling alcoholic beverages on the licensed premises; The sub-lessee is required to allow Division inspection of it's premises at all reasonable times; The applicant discloses the existence of the sub-lease and identifies the sub-lessee, along with the portion of the licensed premises occupied by the sub-lessee, in its license application; and The applicant acknowledges that it is responsible for the actions of the sub-lessee, it's employees and agents on the licensed premises in accordance with the applicant's obligations pursuant to the licensing requirements of Title 28-A and this chapter; and An applicant for license may use neither the inventory nor the assets of the sub-lessee in order to meet the licensing requirements of this chapter. E. Off Premise Retailer Disclosure Rev 8/2016 American LegalNet, Inc. www.FormsWorkFlow.com Bureau of Alcoholic Beverages and Lottery Operations Division of Liquor Licensing & Enforcement DIVISION USE ONLY 8 State House Station, Augusta, ME 04333-0008 Approved 10 Water Street, Hallowell, ME 04347 Tel: (207) 624-7220 Fax: (207) 287-3434 Not Approved Email Inquiries: MaineLiquor@maine.gov BY: OFF PREMISE DIAGRAM In an effort to clearly define your license premise and the area that storage of liquor is allowed. The Division requires all applicants to submit a diagram of the premise to be licensed in addition to a completed license application. Diagrams should be submitted on this form and should be as accurate as possible. Be sure to label the areas of your diagram including entrances, office area, malt and wine coolers, cold and regular storage areas, display cases and shelves, restrooms, check out register(s) and all areas that you are requesting approval from the Division for your retail liquor license. Off Premise Retailer Disclosure Rev 8/2016 American LegalNet, Inc. www.FormsWorkFlow.com