For Questions call (614) 644-3155 Office Hours 8:00 a.m. - 5:00 p.m. OHIO DEPARTMENT OF COMMERCE DIVISION OF LIQUOR CONTROL 6606 TUSSING ROAD, P.O. BOX 4005 REYNOLDSBURG, OHIO 43068-9005 http://www.com.ohio.gov/liqr DUPLICATE BAR APPLICATION CAUTION: ALLOW 10 TO 12 WEEKS FOR PROCESSING THE FOLLOWING ITEM MUST BE SUBMITTED ALONG WITH THIS APPLICATION FOR PROCESSING A proper Permit Class Fee, (See class list below with designated fee). Check made payable to the Division of Liquor Control. § 4303.30 Duplicate permits. The rights granted by any D-2, D-3, D-3a, D-4, D-4a, D-5, D-5a, D-5b, D-5e, D-5f, D-5g, D-5h, D-5i, D-5j, D-5k, D-5l, D-5m, D-5n, D-5o, or D-6 permit shall be exercised at not more than two fixed counters, commonly known as bars, in rooms or places on the permit premises, where beer, mixed beverages, wine, or spirituous liquor is sold to the public for consumption on the premises. For each additional fixed counter on the permit premises where those beverages are sold for consumption on the premises, the permit holder shall obtain a duplicate D-2, D-3, D-3a, D-4, D-4a, D-5, D-5a, D-5b, D-5e, D-5f, D-5g, D-5h, D-5i, D-5j, D-5k, D-5l, D-5m, D-5n, D-5o, or D-6 permit. The holder of any D-2, D-3, D-3a, D-4, D-4a, D-5, D-5a, D-5b, D-5e, D-5f, D-5g, D-5h, D-5i, D-5j, D-5k, D-5l, D-5m, D-5n, D-5o, or D-6 permit shall be granted, upon application to the division of liquor control, a duplicate D-2, D-3, D-3a, D-4, D-4a, D-5, D-5a, D-5b, D-5e, D-5f, D-5g, D-5h, D-5i, D-5j, D-5k, D-5l, D-5m or D-6 permit for each additional fixed counter on the permit premises at which beer, mixed beverages, wine, or spirituous liquor is sold for consumption on the premises, provided the application is made in the same manner as an application for an original permit. ...The application shall identify by name, or otherwise amply describe, the room or place on the premises where the duplicate permit is to be operative... Note: The holder of a D-1, D2X, or D-3X permit is not required to obtain a duplicate bar permit if the additional bar is exclusively used for the sale of beer only, or wine only if a D-3X. An A-1-A duplicate bar permit is only required with a D6. DUPLICATE BAR WITHOUT SUNDAY PRIVILEGES (NO D6) D-2 D-3 D-3 & D3A D3 & D3X D3, D3A & D3X D-4 D-4A D-5 D-5A D-5B D-5E $100.00 $400.00 $800.00 $400.00 $800.00 $200.00 NO FEE $1,000.00 $1,000.00 $1,000.00 $650.00 D-5F D-5G D-5H D-5I D-5J D-5K D-5L D-5M D-5N D-5O $1,000.00 NO FEE NO FEE NO FEE NO FEE NO FEE NO FEE $1,000.00 NO FEE $1,000.00 DUPLICATE BAR WITH SUNDAY PRIVILEGES (INCLUDES D6) A1A & D6 $100.00 D5B & D6 $1,200.00 D2 & D6 $200.00 D5E & D6 $780.00 D3, D6 $500.00 D5F & D6 $1,200.00 D3, D3A & D6 $960.00 D5G & D6 $100.00 D3, D3X & D6 $500.00 D5H & D6 $100.00 D3, D3A & D3X & D6 - $960.00 D5I & D6 $100.00 D2, D3 & D6 $600.00 D5J & D6 $100.00 D2, D3, D3A & D6$1,080.00 D5K & D6 $100.00 D4 & D6 $300.00 D5L & D6 $100.00 D4A & D6 $100.00 D5M & D6 $100.00 D5 & D6 $1,200.00 D5N & D6 $100.00 D5A & D6 $1,200.00 D5O & D6 $1,200.00 ALL QUESTIONS MUST BE ANSWERED TYPE OR PRINT PLAINLY SECTION A Sole Proprietor Name, Corporate or LLC entity, or Partnership Name: Permit Certificate #: Location of Duplicate Bar (i.e., 2nd Floor banquet room): Permit Premises Address: Township (if outside city limits): Residence Phone #: Address: Attorney's Name: City, State, & Zip: City: Zip Code: Business Phone #: County: Phone # Coder: Taxing District: Permit Number Trans. Code DLC 4258 Bus. Type CLASS FOR DIVISION USE ONLY REMARKS: RCPT# REVIEWER ACTION: EOE/ADA SERVICE PROVIDER PAGE 1 FOR TTY USERS DIAL ORS 1-800-750-0750 REV. 9-10 American LegalNet, Inc. www.FormsWorkFlow.com SECTION B 1. Has the permit holder, any partner, officer, managing member, or 5% or more stockholder or member been convicted of any crime not previously reported by the permit holder to this Division? If YES, list and explain. 2. Have there been any ownership, officer, or managing member changes concerning this business? If YES, please explain: 3. Does the permit holder currently own or rent the permit premises? If neither box is checked, please explain: 4. Is this permit business currently open and selling alcoholic beverages on a regular basis? DELIBERATE MISREPRESENTATION OF ANY OF THE INFORMATION ON THE APPLICATION CAN RESULT IN THE DIVISION'S REFUSING TO APPROVE THIS APPLICATION. YES NO YES NO YES NO YES NO THE FOLLOWING MUST BE COMPLETED BY THE APPLICANT(S): State of Ohio, I, County, ss _______________________________________________ being first duly sworn, according to law, depose and say (Please Print) that the statements and answers made in the foregoing application are true. _______________________________________________________________________________ _____________________ (Signature of Individual, Partner, Officer, Managing Member, or 5% or more Stockholder or Member) (Title) _______________ (Date) (Residence Address) (City) (State) (Zip Code) (Area Code & Telephone No.) (To be completed by Notary Public) Sworn to before me and subscribed in my presence this ______________day of _____________________________________, 20 _____________. ________________________________________ (Notary Public) _______________ (Notary Expiration) NOTE: ALL DOCUMENTS WILL BECOME PART OF THE PERMIT FILE AND NOT RETURNED PAGE 2 American LegalNet, Inc. www.FormsWorkFlow.com