Notification Of Forfeiture Of Keg Registration Deposit
Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Notification Of Forfeiture Of Keg Registration Deposit Form. This is a New York form and can be use in Division Of Alcoholic Beverage Control Statewide.
Loading PDF...
Tags: Notification Of Forfeiture Of Keg Registration Deposit, New York Statewide, Division Of Alcoholic Beverage Control
Send to:
Notification of Forfeiture
Keg Registration Deposit Forfeiture Unit
Office of Counsel
Division of Alcoholic Beverage Control
80 South Swan Street – Suite 900
Albany, NY 12210-8002
of
New York
State Liquor
Authority
Keg Registration Deposit
in accordance with ABCL § 105-c.(5-a)
The $50.00 Keg Registration Deposit
which was deposited by the purchaser and left with the seller
in connection with the purchase and sale of a keg of beer
has been forfeited to the seller for the following reason:
Seller:
Check One Box:
Keg was not returned.
Keg was returned but after 90 days from purchase.
Registration label was removed.
Registration label was damaged.
Date
Printed Name of Person sending this form
Signature of Person sending this form
SELLER OF THE KEG OF BEER
Selling Licensee’s Alcoholic Beverage License Number:
Name of the Licensee selling the Keg (PRINTED):
Address of the Licensee selling the Keg (PRINTED):
SALE ITEM AND DATE
Product Brand:
Size of Keg:
Product Brand and Size of Keg:
Date and Time of Sale:
/
Month
:
/
Day
Year
Hour
Minute
AM or PM
PURCHASER OF THE KEG OF BEER
Name of the PURCHASER of the Keg (PRINTED):
Address of the PURCHASER of the Keg (PRINTED):
American LegalNet, Inc.
www.FormsWorkflow.com
