The Commonwealth of Massachusetts Department of the State Treasurer Alcoholic Beverages Control Commission 239 Causeway Street Boston, MA 02114 Salesman/Transportation Renewal Procedures Applications are enclosed to renew your Salesman and Transportation permits for the calendar year. (PLEASE TYPE OR PRINT CLEARLY) All renewal applications and permit fees should be submitted by November 30th of the calendar year. OUR WEBSITE ADDRESS: www.mass.gov/abcc Information on the applications should be typed or printed clearly. If we cannot read the Vehicle Identification numbers on the Transportation application (s), the application will be returned. PAYMENT AND MAILING PROCEDURES ALL APPLICANTS MUST COMPLETE THE ENCLOSED MONETARY TRANSMITTAL FORM, ATTACHING YOUR PAYMENT AND APPLICATION TO THE TRANSMITTAL FORM AND MAIL TO: ALCOHOLIC BEVERAGES CONTROL COMMISSION POST OFFICE BOX 3396 BOSTON, MA 02241-3396 SALESMAN/TRANSPORTATION APPLICATION At the top right of each Salesman’s permit application is SP -…… . Each salesman renewing his/her permit must put the SP NUMBER assigned last year (this number is on their 2008 permit). The Salesman must complete and sign the front of the application. The back of the application, under certificate of employment, must be completed and signed by an officer of the corporation. NOTE: Proof of Massachusetts residency is not required to be submitted with the salesman’s renewal application as a copy should already be on file with this Commission. It is only required for NEW salesmen. NEW SALESMEN MUST SUBMIT AN AFFIDAVIT AND SUBMIT WITH PROOF American LegalNet, Inc. www.FormsWorkFlow.com TRANSPORT/DELIVER APPLICATION (Please type or print information clearly, especially the Vehicle Identification Numbers.) Enclosed are Transport/Deliver applications for your truck fleet. If you wish to license a number of vehicles, you need only complete one transportation application, state on the application the number of vehicles to be licensed and attach a list of the Vehicle Identification Numbers. The application must be signed by any officer of the corporation. At the top right of each Transportation application is the letters TD….., please put the TD number assigned last year (located on last year’s permit) on this year’s renewal application. This number remains the same and by including it on this year’s renewal, it will expedite the renewal process. NOTE: If a vehicle is leased or rented, a copy of the leasing or rental agreement must accompany the transportation application unless a copy is already on file with this Commission. (THIS IS ALSO REQUIRED FOR LEASED OR RENTED VEHICLES OF SALESMEN.) FEES: SALESMAN PERMIT FEE: $200.00. SALESMAN/TRANSPORTATION PERMIT FEE: $200.00 FOR THE SALESMAN PERMIT, PLUS $150.00 FOR THE TRANSPORTATION $350.00 TOTAL TRANSPORT AND DELIVER PERMIT FEE: $150.00 (FOR EACH VEHICLE TO BE LICENSED). ATTESTATION CERTIFYING THE FILING AND PAYMENT OF STATE TAXES SALESMAN/TRANSPORT APPLICATION - The attestation is located on the back of the Salesman/Transportation application. The attestation is to be completed and signed by the individual salesman with his or her Social Security Number. TRANSPORT AND DELIVER APPLICATION - The attestation is located on the back of the Transport and Deliver application. You need only complete ONE attestation to cover all vehicles you wish licensed. The attestation must be signed by an Officer of the Corporation, and state the Federal Identification Number. 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 Application for a Salesman's Permit to solicit orders for alcoholic beverages under provisions of Section 19A, Chapter 138 of the General Laws, as Amended 2010 SP __________ The undersigned hereby applies for a Salesman's Permit to solicit orders for alcoholic beverages on behalf of: …………………………………………………………………………………LICENSE NO: …………… (Name of licensee by whom applicant is employed) Address of Employer’s Place of Business:…………………………………………………………….. Have you been convicted of a felony within the past five years? Have you been convicted of a misdemeanor under the Laws of the United States or of the Commonwealth of Massachusetts relating to the sale of alcoholic beverages within the past three years? ..………………………………………………………………………………………………. ………………………………………………………………………………………………… (If your answer to either or both of the above questions is in the affirmative, give full and detailed information as to when, where and with what result) THE ABOVE STATEMENTS ARE MADE UNDER THE PENALTIES OF PERJURY. Permit Fee $200.00 Signature of Applicant ………………………………………… Enclosed find Check ……………………… (PRINT NAME)……………………………………… Home Address ………………………………………. ………………………………………………………... MASSACHUSETTS ZIP CODE ………………………………………………………... (TELEPHONE NUMBER) FORM 12 American LegalNet, Inc. www.FormsWorkFlow.com CERTIFICATE OF EMPLOYMENT The undersigned, being the holder of a ……………………………………………License No. ………………… for the sale of beverages ...................................…………………………………………………………beverages hereby certifies that ………………………………………………………………………………………………... (PRINT OR TYPE NAME) is employed as a salesman, and it is agreed that immediate notice will be sent to the Alcoholic Beverages Control Commission if at any time he ceases to be so employed. ………………………………………………………………………… Signature-Title * SATISFACTORY EVIDENCE THAT THE APPLICANT IS A CITIZEN OF THE COMMONWEALTH OF MASSACHUSETTS MUST BE SUBMITTED WITH THIS APPLICATION * 1. Voter’s Certificate and Affidavit – OR- * 2. Birth Certificate and Affidavit – OR *3· Naturalization Papers and Affidavit Pursuant to M.G.L. Chap. 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 ____________________________________________ Signature of Individual Date APPLICATION FOR A LICENSEE'S PERMIT TO TRANSPORT AND DELIVER CERTAIN ALCOHOLIC BEVERAGES Under Section 22 of Chapter 138 of the General Laws, as Amended Permit Fee $150.00 Make and type of vehicle ................................................................................................................. (State where vehicle is registered) Motor vehicle identification number ………………………………………………………………………………. Usually garaged or kept at …………………………………………………………………………………………. Name and address of the registrant………………………………………………………………………………… NOTE: Section 22 referred to above provides in part as follows “Licenses for the sale of alcoholic beverages or alcohol, as the case may be, may transport and deliver anywhere in the Commonwealth alcoholic beverages or alcohol lawfully bought or sold by them in vehicles owned or leased by them or their employees, if each vehicle used for transportation and delivery is covered by a permit issued by the commission, provided that vehicles owned or leased by holders of permits under section nineteen A (Salesman) shall be used only for the transportation of samples”. (If the vehicle is leased by the applicant or his employee this application shall be accompanied by a copy of written authorization for its use to transport and delivery alcoholic beverages unless this information has been furnished to the Commission in connection with a previous application). American LegalNet, Inc. www.FormsWorkFlow.com LICENSEE NAME: LICENSE NO.: ALL NEW APPLICANTS MUST SUBMIT THIS AFFIDAVIT DATE __________________ I, _________________________was born_____________________________________ Input Date of Birth in______________________________________________________________________ City or Town State My legal residence is now: Street and Number MUST BE FROM ___________________________________________________MASSACHUSETTS City or Town Signed________________________________________ Above statement MUST be accompanied by: (1) Birth Certificate, or (2) Voter’s Registration, or (3) Naturalization Papers THE ABOVE STATEMENT ARE MADE UNDER PENALTY OF PERJURY American LegalNet, Inc. www.FormsWorkFlow.com MONETARY TRANSMITTAL FORM 3 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: DATE: LICENSE NAME STATE: ZIP CODE: # of permits, LICENSES, REV. CODE REQUESTED COMMERCIAL ALCOHOL 3008 MANUFACTURERS, ALCOHOLIC BEV. 3005 FARMER WINERY 3005 FARMER BREWERY 3005 PUB BREWERS 3005 MANUFACTURERS, WINE & MALT 3005 WHOLESALERS ALL AB 3006 WHOLESALERS WM 3006 WHOLESALERS SAC 3006 SALESMAN 3011 TRANSP. FOR SALESMAN 3097 STORAGE 3095 TRANSPORTATION & DELIVERY 3097 CERTIFICATE OF COMPLIANCE 2.17 REGISTRATION 3095 ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ FEE AMOUNT TOTAL $ 500.00 ________ $ 9000.00 ________ $22.00 - $110.00 ________ $22.00 - $110.00 ________ $ 1000.00 ________ $ 4500.00 ________ $ 10000.00 ________ $ 5000.00 ________ $ 3000.00 ________ $ 200.00 ________ $ 150.00 ________ $ 2000.00 ________ $ 150.00 ________ $ 1000.00 CHECK TOTAL ________ $ ________ 10/04 REV. American LegalNet, Inc. www.FormsWorkFlow.com