Manufacturer License & Permit Application For Out-of-State ApplicantsMichigan Department of Licensing and Regulatory AffairsLiquor Control Commission (MLCC) Toll-Free: 866-813-0011 - www.michigan.gov/lcc For more information on manufacturer and wholesaler licenses and permits, please visit the Liquor Control Commission's frequently asked questions website by clicking this link .Before you begin filling out the attached application, please review this checklist for the forms and documents you will need to submit with your completed application form Completed Manufacturer License & Permit Application for Out-of-State Applicants (Form LCC-151, attached) Copy of Federal Basic Permit Surety Bond executed by an insurance company in the amount of $1,000.00 (Form LC-MW-816) - Only required for Outstate Seller of Wine, Outstate Seller of Mixed Spirit Drink, or Outstate Seller of Beer applicants. Inspection, License, and Permit Fees Purchase agreement - For the transfer of ownership of a license If applicant is a corporation also include (pursuant to R 436.1109): Copy of the operating agreement or bylaws of the applicant companyIf applicant is a limited partnership also include (pursuant to R 436.1111): Each general partner of a partnership shall sign the application, bond, and other papers filed in connection with securing Copy of the partnership agreement of the applicant limited partnership Copy of Articles of Organization from the state of issuance.If applicant is a limited liability company also include (pursuant to R 436.1110): Copy of Articles of Incorporation from the state of issuance. Report of Stockholders/Member/Partners (Form LCC-301) Certified copy of the minutes of a meeting of its board of directors or a statement signed by an officer of the corporation naming the persons authorized by corporate resolution to sign the application and other documents required by the Commission or Part 3 of Form LCC-301. Statement signed by a manager of the limited liability company or by at least 1 member if management is reserved to the members naming the person authorized to sign the application and other documents required by the Commission or Part 3 of Form LCC-301.a new license or transferring an existing license. This requirement may be waived by the Commission upon showing of good cause, which must be submitted in writing. Report of Stockholders/Member/Partners (Form LCC-301) Report of Stockholders/Member/Partners (Form LCC-301) Current Certificate of Good Standing from the state where incorporated and Certificate of Authority to Do Business in Michigan. A Certificate of Authority to Do Business in Michigan is not required if corporation is not transacting business in Michigan as defined under MCL 450.2012. Current Certificate of Authority to Do Business in Michigan. A Certificate of Authority to Do Business in Michigan is not required if limited liability company is not transacting business in Michigan as defined under MCL 450.5008. Point of Contact Information (Form LCC-306, attached) American LegalNet, Inc. www.FormsWorkFlow.com Michigan Department of Licensing and Regulatory AffairsLiquor Control Commission (MLCC) Toll-Free: 866-813-0011 - www.michigan.gov/lcc Business ID: Request ID:(For MLCC Use Only)For information on manufacturer licenses and permits, including a checklist of required documents for a completed application, please visit the Liquor Control Commission's frequently asked questions website by clicking this link .Part 1 - Applicant Information Individuals, please state your legal name. Corporations or Limited Liability Companies, please state your name as it appears on your Articles of Incorporation / Organization.Is this an application for a new license or the transfer of ownership of an existing license? New License License TransferPart 2 - License Transfer Information (If Applicable)Current licensee(s):Address: Manufacturer License & Permit Application For Out-of-State Applicants City:State:Zip Code: Part 3 - Licenses, Permits, and Permissions Applicants for Manufacturer licenses or permits must complete the attached Schedule A and return it with this application. Transfer the fee calculations from the Schedule A to Part 4 below. Part 4 - Inspection, License, and Permit Fees - Make checks payable to State of Michigan Inspection Fees - Pursuant to MCL 436.1529(4) a nonrefundable inspection fee of $70.00 shall be paid to the Commission by an applicant or licensee at the time of filing of a request for a new license or permit or a request to transfer ownership of a license. No inspection fee is charged for a Limited Alcohol Buyer or Seller of Alcohol license. License and Permit Fees - Pursuant to MCL 436.1525(1), license and permit fees shall be paid to the Commission for a request for a new license or permit or to transfer ownership or location of an existing license.Inspection Fees: License Fees: TOTAL FEES: (MLCC Fee Code 4036)(MLCC Fee Code 4038) Applicant name:Doing Business As (DBA) Name:Address:Mailing Address (if different than above):City:Contact Name:Phone:Email:State:Zip Code:City:State:Zip Code: Federal Employer Identification Number (FEIN): Part 5 - Disclosure of Interest in a Michigan License Have you ever been licensed by the Michigan Liquor Control Commission (MLCC) or do you currently hold an interest in any other licenses issued by the MLCC? No YesIf Yes, please explain:Page 1 of 3LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities. LCC-151 (06-17) American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 3LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities. Date Signature of Applicant Print Name of Applicant & TitlePart 6 - Signature of Applicant I certify that the information contained in this form is true and accurate to the best of my knowledge and belief. I agree to comply with all requirements of the Michigan Liquor Control Code and Administrative Rules. I also understand that providing false or fraudulent information is a violation of the Liquor Control Code pursuant to MCL 436.2003.LCC-151 (06-17)Please return this completed form along with corresponding documents and fees to: Michigan Liquor Control Commission Mailing address: P.O. Box 30005, Lansing, MI 48909 Hand deliveries or overnight packages: Constitution Hall - 525 W. Allegan, Lansing, MI 48933 Fax to: 517-284-8557 American LegalNet, Inc. www.FormsWorkFlow.com License Type:$1,000.00License Type: Source or origin of shipments:10.00 Seller of AlcoholBase Fee:License Type:Base Fee: Limited Alcohol Buyer10.00 Outstate Seller of BeerBase Fee:License Type:Base Fee: Outstate Seller of Wine$300.00Check all that apply: Located in the U.S. (including Michigan) and will import and sell foreign beer to Michigan wholesalers Located outside Michigan, but inside the U.S., and will manufacture and package own beer for sale to Michigan wholesalers Have been designated as the sole and exclusive sale agent in Michigan by the manufacturer of he beer, not to exceed 5,000 barrels per manufacturer per calendar year Source or origin of shipments to Michigan: Do you want to purchase from:For resale? State Seller of Alcohol Licensee Use of alcohol: No YesPage 3 of 3LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities. Schedule A - Licenses and PermitsCheck all that apply: Will import foreign product and ship to Michigan Wholesalers Will produce and bottle own product Will ship and sell bulk product to Michigan Manufacturers for blending and rectifying purposes or for non-beverage purposes Will sell bottled products to clergy for sacramental purposes Will bottle product produced by another person Will own the product manufactured by another person Have been designated as the sole and exclusive sales agent in the U.S. by the manufacturer of the product (not imported product) Will purchase product from an U.S. manufacturer, not t