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Teen Night Notification Form. This is a New York form and can be use in Division Of Alcoholic Beverage Control Statewide.
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Tags: Teen Night Notification, New York Statewide, Division Of Alcoholic Beverage Control
ALCOHOL FREE TEEN EVENTS
On-premises licensees planning alcohol free teen events are required by law to notify the State Liquor
Authority (SLA) in writing 10 days prior to holding such activity at their establishment. The Authority
has promulgated a notification form which can be downloaded from this site for submission to the
appropriate SLA Zone Office by either fax or mail. It is not necessary that you use this form, but your
written notification must contain all the required information. The following are the addresses and
fax numbers for the SLA Office in your zone. To locate your county area, go to Licensing Information
and click on “Where Do I File?”
ZONE I – NEW YORK CITY
New York State Liquor Authority
317 Lenox Avenue
New York, New York 10027
Attn: Enforcement Bureau
Fax: (212) 961-8381
ZONE II – ALBANY/SYRACUSE DISTRICT
New York State Liquor Authority
80 S. Swan St., Suite 900
Albany, New York 12210
Attn: Enforcement Bureau
Fax: (518) 473-7527
ZONE III- BUFFALO
New York State Liquor Authority
535 Washington St., Suite 303
Buffalo, New York 14203
Attn: Enforcement Bureau
Fax: (716) 845-5020
Remember: During the teen event(s), no alcoholic beverages shall be sold, served, given away or
consumed by any persons at the establishment. If you decide to cancel the teen event after the written
notification was submitted, you must contact both the police and the SLA as soon as possible prior to
that date.
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TEEN NIGHT NOTIFICATION
Notice must be filed in writing at least 10 days prior to event(s)
As required by Section 260.21.1.(d), I hereby notify the New York State Liquor Authority of the closing
of my establishment to the public for a specified period of time to conduct an activity or
entertainment, during which a child (less than 16 years of age) is in or remains in my establishment
and no alcoholic beverages are sold, delivered, given away or consumed at my establishment during
such period.
Premises License Number
County
Premises Name:
Dba:
Address:
Contact Person:
Telephone Number:
Type of Event
Date
Start Time / Ending Time
1
2
3
4
5
6
7
8
9
10
On ____________________________ (date), I submitted a completed copy of this notice to the
_______________________________________ (name of police department) in my locality.
I will contact the above police department and the New York State Liquor Authority in
advance of any changes (10 days prior) or cancellations to the above scheduled events.
Print Name
Signed:
Title:
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