APPLICATION FOR LIQUOR LICENSE BOAT CHECKLIST NEBRASKA LIQUOR CONTROL COMMISSION 301 CENTENNIAL MALL SOUTH PO BOX 95046 LINCOLN, NE 68509-5046 PHONE: (402) 471-2571 FAX: (402) 471-2814 Website: www.lcc.nebraska.gov Hot List: YES / NO License Number New/Replacing: # Initials §53-123.06 Boat license; rights of licensee. A boat license shall allow the sale of alcoholic liquor in individual drinks, on any passenger boat which maintains a public dining room or restaurant thereon. Applicant Name _________________________________________________________________________ Trade Name __________________________________Previous Trade Name ________________________ E-Mail Address:_________________________________________________________________________ Provide all the items requested. Failure to provide any item will cause this application to be returned or placed on hold. All documents must be legible. Any false statement or omission may result in the denial, suspension, cancellation or revocation of your license. If your operation depends on receiving a liquor license, the Nebraska Liquor Control Commission cautions you that if you purchase, remodel, start construction, spend or commit money that you do so at your own risk. Prior to submitting your application review the application carefully to ensure that all sections are complete, and that any omissions or errors have not been made. You may want to check with the city/village or county clerk, where you are making application, to see if any additional requirements must be met before submitting application to the state. REQUIRED ATTACHMENTS Each item must be checked and included with application or marked N/A (not applicable) _____1. Fingerprints are required for each person as defined in new application guide, found on our website under "Licensing Tab" in "Guidelines/Brochures". See Form 147 for further information, this form MUST be included with your application. _____ 2. Enclose fee of $90 check made payable to the Nebraska Liquor Control Commission or you may pay online at www.ne.gov/go/NLCCpayport. OFFICE USE ONLY PAYMENT TYPE: ____________________ AMOUNT: ______________________ RECEIVED: ______________ BARCODE FORM 132 REV JUNE 2015 PAGE 1 OF 1 American LegalNet, Inc. www.FormsWorkFlow.com ____ 3) Enclose the appropriate application forms; Individual License (requires insert form 1) Partnership License (requires insert form 2) Corporate License (requires insert form 3a & 3c) Limited Liability Company (LLC) (requires form 3b & 3c) _____ 4. If boat is being leased send a copy of signed lease. Be sure the lease reads in the name of the individual(s), corporation or Limited Liability Company making application. Lease term must run through the license year being applied for. ______ 5. If boat is owned or being purchased send a copy of the deed or purchase agreement in the name of the applicant. _____ 6. If buying the business of a current liquor license holder: a) Provide a copy of the purchase agreement from the seller (must read applicants name) b) Provide a copy of alcohol inventory being purchased (must include brand names and container size) c) Enclose a list of the assets being purchased (furniture, fixtures and equipment) _____ 7. If requesting to operate on current liquor license; enclose Temporary Operating Permit (TOP)(form 125). _____ 8. Enclose a list of any inventory or property owned by other parties that are on the premise. _____ 9. For citizenship U.S. birth certificate; U.S. passport or naturalization papers. a. For residency enclose proof of registered voter in Nebraska b. See guideline for further assistance http://www.lcc.nebraska.gov/brochures.html _____10. Corporation or Limited Liability Company must enclose a copy of articles of incorporation; as filed with the Secretary of State's Office. _____11. Submit a copy of your business plan. I acknowledge that this application is not a guarantee that a liquor license will be issued to me, and that the average processing period is 60 days. Furthermore, I understand that all the information is truthful and I accept all responsibility for any false documents. ____________________________________________________________________ Signature ____________________ Date FORM 132 REV JUNE 2015 PAGE 1 OF 2 American LegalNet, Inc. www.FormsWorkFlow.com APPLICATION FOR LIQUOR LICENSE BOAT NEBRASKA LIQUOR CONTROL COMMISSION 301 CENTENNIAL MALL SOUTH PO BOX 95046 LINCOLN, NE 68509-5046 PHONE: (402) 471-2571 FAX: (402) 471-2814 Website: www.lcc.nebraska.gov/ CLASS OF LICENSE FOR WHICH APPLICATION IS MADE AND FEES CHECK DESIRED CLASS Class O Boat Application fee $45 plus licensee fee $50 (check made payable to Nebraska Liquor Control Commission) Additional fees will be assessed at city/village or county level when license is issued Term of license runs from May 1 ­ April 30 CHECK TYPE OF LICENSE FOR WHICH YOU ARE APPLYING Individual License (requires insert form 1) Partnership License (requires insert form 2) Corporate License (requires insert form 3a & 3c) Limited Liability Company (LLC) (requires form 3b & 3c) NAME OF ATTORNEY OR FIRM ASSISTING WITH APPLICATION (if applicable) Commission will call this person with any questions we may have on this application Name_______________________________________________ Phone number:________________________________ Firm Name_______________________________________________________________________________________ FORM 132 REV JUNE 2015 PAGE 1 OF 3 American LegalNet, Inc. www.FormsWorkFlow.com PREMISE INFORMATION Trade Name (doing business as)______________________________________________________________________ Street Address #1_________________________________________________________________________________ Street Address #2_________________________________________________________________________________ City____________________________________County____________________________Zip Code_______________ Premise Telephone number_____________________________________ Business e-mail address _______________________________________ Is this location inside the city/village corporate limits: Mailing address (where you want to receive mail from the Commission) Name________________________________________________________________________________________ Street Address #1_______________________________________________________________________________ Street Address #2_______________________________________________________________________________ City___________