The Commonwealth of Massachusetts Department of the State Treasurer Alcoholic Beverages Control Commission 239 Causeway Street Boston, MA 02114 AIRLINE LICENSE APPLICANTS (M.G.L. CH. 138, S. 13) Procedures to apply for or renew a license Important - payment and mailing procedures All applicants must complete the enclosed monetary transmittal form, attach your payment and application to the transmittal for and mail to: Alcoholic Beverages Control Commission C/O Bank of America, Post Office Box 3396 Boston, MA 02241-3396 Enclosed is an application to apply for an Airline license (to sell or transport alcoholic beverages) or to renew your license. The following must accompany your application: LICENSE FEE: TO SELL: (Payable to the Commonwealth of Massachusetts) $500.00 for the Master License and $50.00 for each Certified Copy. TO TRANSPORT: $1,500.00, requirements of the Public Health Security and Bioterrorism Preparedness and Response Act of 2002, Public Law 107-188 (“the Bioterrorism Act of 2002.”) ARTICLES OF ORGANIZATION: (a) NEW APPLICANTS If applicant is a Corporation, submit APPROVED copy of Articles of Organization issued by the Secretary of State of Massachusetts. (b) RENEWAL APPLICANTS Copy of approved articles of organization are required only if there have been any changes/amendments in the articles currently on file with this commission. Renewal applications MUST be submitted by NOVEMBER 30th of the calendar year. Website address: www.mass.gov/abcc Any questions please call, Theresa Strianese (617) 727-3040 x 21. American LegalNet, Inc. www.FormsWorkFlow.com The Commonwealth of Massachusetts Department of the State Treasurer Alcoholic Beverages Control Commission 239 Causeway Street Boston, MA 02114 2010 AIRLINE TRANSPORTATION APPLICATION (M.G.L. CH. 138, SEC. 22) NAME OF AIRLINE:____________________________________________________________ ADDRESS:____________________________________________________________________ TELEPHONE NUMBER (AREA CODE): ___________________________________________ The undersigned being a Common Carrier by Air operating out of the port of _____________, Massachusetts, hereby applies for a permit to TRANSPORT alcoholic beverages not to be consumed by passengers in its aircraft during the year 20_____. Have you registered with the Food and Drug Administration?________________ FDA Registration No. ____________________ Date of Registration___________ The foregoing statements are made under the penalties of perjury. Signature__________________________________________ (DATE) Title_______________________________________ IMPORTANT NOTICE PAYMENT AND MAILING PROCEDURES All applicants must complete a monetary transmittal form. Attach your payment and application to the transmittal form and mail to: ALCOHOLIC BEVERAGES CONTROL COMMISSION POST OFFICE BOX 3396 BOSTON, MA 02241-3396 FEE: $1,500.00 (CHECK PAYABLE TO THE COMMONWEALTH OF MASSACHUSETTS) The Commonwealth of Massachusetts Department of the State Treasurer Alcoholic Beverages Control Commission 239 Causeway Street Boston, MA 02114 American LegalNet, Inc. www.FormsWorkFlow.com 2010 AIRLINE LICENSE APPLICATION (M.G.L. Ch. 138, Sec. 13) APPLICANT NAME:___________________________________________________________________________ ADDRESS:___________________________________________________________________________________ TELEPHONE NUMBER (AREA CODE): __________________________________________________________ The undersigned being an Airline Corporation operating an airline within the Commonwealth, hereby applies for a license to sell alcoholic beverages to passengers for consumption in its aircraft. Describe the aircraft to be licensed (give names, numbers or scheduled flight numbers, and type of aircraft). Please attach additional page if more space is needed. ____________________________________________________________________________________________ ____________________________________________________________________________________________ The foregoing statements made under the penalties of perjury. Signature _______________________________________________________ Date Title____________________________________________________________ Pursuant to M.G.L. Ch. 62C, Sec. 49A, I certify under the penalties of perjury that I, to my best knowledge and belief, have filed all state tax returns and paid all state taxes required under law. _________________________ Social Security Number _____________________________ Federal Identification Number ________________________________ Signature of Individual or Corporate Name ____________ Date by:________________________________ Corporate Officer Date (If applicable) FEE: $500.00 PLUS $50.00 FOR EACH CERTIFIED COPY, PAYABLE TO THE COMMONWEALTH OF MASSACHUSETTS American LegalNet, Inc. www.FormsWorkFlow.com MONETARY TRANSMITTAL FORM 1 THIS TRANSMITTAL MUST ACCOMPANY YOUR APPLICATION IN ORDER TO ASSURE PROPER CREDIT. PLEASE DO NOT SEND CASH. PLEASE MAKE YOUR CHECKS PAYABLE TO COMMONWEALTH OF MASSACHUSETTS, ABCC. MAIL THIS TRANSMITTAL ALONG WITH YOUR CHECK AND COMPLETED APPLICATION TO: BANK OF AMERICA - ALCOHOLIC BEVERAGES CONTROL COMMISSION POST OFFICE BOX 3396 BOSTON, MA 02241-3396 APPLICANT MUST COMPLETE THE FOLLOWING: NAME: _______ ADDRESS: CITY/TOWN: STATE: ZIP CODE: DATE: LICENSE NAME AIRLINE MASTER FOR SALE TO PASSENGERS AIRLINE (EACH FLIGHT) BROKERS BONDED WAREHOUSE SALESMAN TRANSP. FOR SALESMAN RAILROAD MASTER FOR SALE TO PASSENGERS RAILROAD (EACH RR CAR) STEAMSHIP SHIP CHANDLER TRANSPORTATION & DELIVERY WAREHOUSEMAN PERMIT TO TRANSPORT NOT FOR CONSUMPTION RR, SHIP, OR AIRLINE REV. CODE # OF PERMITS REQUESTED FEE AMOUNT TOTAL 3094 3094 3007 3095 3011 3097 ________ ________ ________ ________ ________ ________ $ 500.00 $ 50.00 $ 5000.00 $ 1000.00 $ 200.00 $ 150.00 $______ $______ $______ $______ $______ $______ 3009 3009 3010 3099 3097 3095 ________ ________ ________ ________ ________ ________ $ 500.00 $ 50.00 $ 500.00 $ 1000.00 $ 150.00 $ 500.00 $______ $______ $______ $______ $______ $______ 3097 ________ $ 1500.00 $______ CHECK TOTAL $_________ 10/03 REV American LegalNet, Inc. www.FormsWorkFlow.com