NORTH CAROLINA ALCOHOLIC BEVERAGE CONTROL COMMISSION Location: 400 E. Tryon Road Raleigh, NC 27610 919-779-0700 Permit # _____________________ Date Issued: __________________ MAIL OR FAX TO ADDRESS LISTED BELOW (Do not write above this line) APPLICATION FOR COMMERCIAL TRANSPORTATION PERMIT Beer/Wine Transportation Permit Spirituous Liquor Transportation Permit Both Name of Motor Carrier: Physical Address: Street/Route City State Zip Code Mailing Address: Street/Route City State Zip Code Business Phone #: Contact Person: Fax #: Application is hereby made for a fleet alcoholic beverages transportation permit to be issued to the above named carrier. I understand that a copy of the original fleet permit must be certified by affixing the carrier's corporate seal and placed in each power unit hauling alcoholic beverages into or through North Carolina. NOTE: A Surety Bond must accompany this application if applying for a Spirituous Liquor Transportation Permit. FAX TO: MAIL TO: 919-662-3583 NC Alcoholic Beverage Control Commission 4307 Mail Service Center Raleigh, NC 27699-4307 American LegalNet, Inc. www.FormsWorkFlow.com