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New Brand Registration Application Form. This is a New Jersey form and can be use in Division Of Alcoholic Beverage Control Statewide.
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Tags: New Brand Registration Application, New Jersey Statewide, Division Of Alcoholic Beverage Control
STATE OF NEW JERSEY
DEPARTMENT OF LAW AND PUBLIC SAFETY
DIVISION OF ALCOHOLIC BEVERAGE CONTROL
P.O. BOX 087
TRENTON, NEW JERSEY 08625-0087
NEW BRAND REGISTRATION APPLICATION
(N.J.S.A. 33:1-2; N.J.A.C. 13:2-33)
ALL INFORMATION MUST BE PRINTED OR TYPED
FILING FEE:
$23 PER PRODUCT
PLEASE MAKE THE CHECK PAYABLE TO THE DIVISION OF ABC
FILING STATUS: BRAND OWNER (
) or AUTHORIZED AGENT (
)
BRAND (PRODUCT) REGISTRANT: N.J. LICENSE NUMBER (IF ANY)
NAME:
ADDRESS:
CONTACT PERSON:
CHECK ONE CLASSIFICATION:
PHONE NUMBER:
WINE (
)
BEER* (
)
DISTILLED SPIRITS (
)
HAVE THE PRODUCTS LISTED BELOW RECEIVED LABEL APPROVAL FROM THE FEDERAL ALCOHOL
AND TOBACCO TAX AND TRADE BUREAU?
YES ( ) NO ( )
IF AUTHORIZED AGENT, DOES REGISTRANT HAVE LETTER OF AUTHORIZATION FROM THE BRAND
OWNER?
YES ( ) NO ( )
(OFFICE USE ONLY)
REGISTRATION NUMBER
PRODUCT [LABEL] NAME & VINTAGE IF APPLICABLE
1. _____________________________________________________
_____________________________
LIST ALL VINTAGES: ______, ______, ______, ______,______
2. _____________________________________________________
_____________________________
LIST ALL VINTAGES: ______, ______, ______, ______,______
3. _____________________________________________________
_____________________________
LIST ALL VINTAGES: ______, ______, ______, ______, ______
4. _____________________________________________________
_____________________________
LIST ALL VINTAGES: ______, ______, ______, ______, ______
5. _____________________________________________________
_____________________________
LIST ALL VINTAGES: ______, ______, ______, ______, ______
6. _____________________________________________________
_____________________________
LIST ALL VINTAGES: ______, ______, ______, ______, ______
7. _____________________________________________________
_____________________________
LIST ALL VINTAGES: ______, ______, ______, ______, ______
8. _____________________________________________________
_____________________________
LIST ALL VINTAGES: ______, ______, ______, ______, ______
*SEE INSTRUCTIONS IF DEPOSIT INFORMATION APPEARS ON LABEL
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DESIGNATED NEW JERSEY WHOLESALE DISTRIBUTORS
(INCLUDE SELF IF APPLICABLE)
LICENSE NUMBER:
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LICENSEE NAME:
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THE UNDERSIGNED HEREBY CERTIFIES THAT THE LABELS FOR THE PRODUCTS LISTED HAVE BEEN
REGISTERED WITH AND APPROVED BY THE FEDERAL ALCOHOL AND TOBACCO TAX AND TRADE
BUREAU, THAT HE IS THE BRAND OWNER OF LABEL(S) OR HE IS DULY AUTHORIZED TO EXECUTE
THIS APPLICATION AND WILL PRODUCE WITHIN FORTY-EIGHT HOURS UPON DEMAND ANY FEDERAL
LABEL APPROVAL AND/OR AUTHORIZATION.
TYPE OR PRINT AUTHORIZED SIGNATOR
DATE
SIGNATURE
IF YOU HAVE ANY QUESTIONS, PLEASE CALL (609) 984-2371.
REVISED 10/28/10
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