STATE OF NEW JERSEY DEPARTMENT OF LAW AND PUBLIC SAFETY DIVISION OF ALCOHOLIC BEVERAGE CONTROL P.O. BOX 087, 140 EAST FRONT STREET TRENTON, NJ 08625-0087 APPLICATION FOR TRANSIT INSIGNIA [TI] [ALL COMMERCIAL AND NON-COMMERCIAL VEHICLES] EFFECTIVE SEPTEMBER 1, 20____ TO AUGUST 31, 20____ This application must be filed in DUPLICATE and accompanied by a fee of $75.00 per vehicle to be used in the transportation of alcoholic beverages. Fees must be in the form of a company check or money order payable to the Division of Alcoholic Beverage Control. A COPY OF THE MOTOR VEHICLE REGISTRATION CARD ISSUED TO EACH VEHICLE MUST ALSO ACCOMPANY THIS APPLICATION. 1. Name of Licensee:___________________________________________________________ 2. 12-Digit New Jersey Liquor License No.:_______ - ______ - _______ - ________ 3. Company Mailing Address:____________________________________________________ 4. Business Telephone No.: ( VEHICLE MAKE/MODEL/YEAR )_____________________________________________ VIN (LAST 5 DIGITS) OWNED OR LEASED INSIGNIA NO. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. The licensee asserts that the vehicles described in this application will be operated under its exclusive control by its bona fide employees and shall be used for the transportation of alcoholic beverages solely for the licensee’s own business. The licensee hereby consents to inspection and search, without warrant, and at all hours, by the Director, his authorized agents and by other officer as defined by R.S. 33:1-1(p), of any vehicle for which an insignia is issued. __________________________________________ Title and Signature of Licensee ____________________________ Date SIGN, DATE AND INCLUDE REGISTRATION American LegalNet, Inc. www.FormsWorkflow.com