F-2 Permit Application Form. This is a Ohio form and can be use in Department Of Commerce Statewide.
Tags: F-2 Permit Application, DLC 4138, Ohio Statewide, Department Of Commerce
Ohio Department of Commerce Division of Liquor Control 6606 Tussing Road, P.O. Box 4005, Reynoldsburg, Ohio 43068-9005 Telephone No. (614) 644-3155 - Fax No. (614) 644-6965 http://www.com.ohio.gov/liqr F-2 PERMIT APPLICATION Fee: $150.00; $160.00 if issued jointly with the holder of a D-3, D-4 or D-5 permit. An F2 permit may be issued to an association or corporation, or to a recognized subordinate lodge, chapter, or other local unit of an association or corporation organized not for profit and operated for a charitable, cultural, fraternal, or educational purpose to sell beer and intoxicating liquor until 1:00 a.m., at an event not to exceed forty eight consecutive hours. No more than two F2 permits may be issued to any applicant within a calendar year. APPLICATION SHOULD BE FILED THIRTY (30) DAYS PRIOR TO EVENT CAREFULLY READ THE GENERAL INSTRUCTIONS FOR FILING F-2 APPLICATION TYPE OR PRINT PLAINLY ALL QUESTIONS MUST BE ANSWERED Name of Non-Profit Organization (Exact Name must be uniform on all documents) Street Address (Where Function Will Be Held - BE SPECIFIC & must be uniform on all documents) Township (Only if Unincorporated Area) City State Zip Code County: OHIO Mail and/or Fax Permit and Correspondence To: Name: Street Address: State: Zip Code: Individual responsible for the compliance with Ohio's liquor laws in conjunction with the sale and consumption of alcoholic beverages: City: Phone #: Fax #: Name: Title: Phone #: Date and Time Function Will Begin: Date Function Begins: Time Function Begins: am pm Date and Time Function Will End: Date Function Ends: Time Function Ends: am pm The Division of Liquor Control does not regulate or advise individuals regarding gambling in conjunction with the issuance of an F2 permit. Any question regarding gambling should be directed to the Ohio Attorney General's Office, Charitable Gaming Section, 101 East Town Street, Columbus, OH 43215 at (614) 466-3180. SECTION A 1. Has any officer of the applicant organization, or the organization itself ever been convicted of any felony or misdemeanor? If YES, attach a written explanation. YES NO 2. Will a D3, D4 or D5 permit holder be conducting the sale of alcoholic beverages? If YES, this application should be filed jointly. Please indicate below the permit holders name and permit number. YES NO (Note: Both F2 applicant name and issued permit holder name must be on all documents where "Name of Non Profit Organization is requested) Permit Holders Name: Permit Number: FOR OFFICE USE ONLY Taxing District Remarks: Reviewer Action: Permit Number Receipt # DLC 4138 Rev. 4-09 American LegalNet, Inc. www.FormsWorkFlow.com 3. Please check the specific purpose for which your organization operates: Cultural Charitable Fraternal Educational 4. What is the purpose of the function? (Note: The proceeds of the function shall not be used for the profit or gain of any individuals) ___________________________________________________________________________ 5. Will the applicant receive 100% of the proceeds of the function? If "NO", please give detailed explanation: ________________________________________________________________________________________________ YES NO YES NO YES NO YES NO YES NO YES NO YES NO 6. Is applicant a not for profit association, corporation, or a recognized subordinate lodge, chapter, or other local unit of a not for profit association or corporation? 7. If requested, will the applicant provide to the Division of Liquor Control evidence from the Secretary of State's Office that the applicant is a valid not for profit association, corporation, or a recognized subordinate lodge, chapter, or other local unit of a not for profit association or corporation? If NO, please explain: ____________________________________________________________________________ 8. Is applicant affiliated with the holder of any class of liquor permit other than D-4? If YES, please explain: ____________________________________________________________________________ 9. Will any individual or for profit association, corporation, or other legal entity receive any financial profit or gain from the event for which you are requesting the F-2 permit? If YES, please explain, including identity and share of each person to receive profit or gain: _________________________________________________________________________________________________ 10. Will the members of the applicant organization coordinate and operate the event and conduct the sale of alcoholic beverages? If NO, please attach a detailed explanation of the non member involvement and their financial compensation. 11. Will any for profit association, corporation, or other legal entity be involved in the event for which you are requesting the F-2 permit? If YES, please explain: _____________________________________________________________________________ ________________________________________________________________________________________________ THE FOLLOWING MUST BE COMPLETED BY THE APPLICANT(S): NOTE: FALSIFICATION OF ANY OF THE INFORMATION ON THIS APPLICATION CAN RESULT IN THE DIVISION'S REFUSING TO ISSUE THIS PERMIT State of Ohio, ___________________________________County, ss I/We ___________________________________________________, being first duly sworn, according to law, depose and say that I/We are at least twenty-one (21) years of age and the statements and answers made in the foregoing application are true. With respect to the F-2 permit, I/We agree to comply with all applicable statutes and rules. I/We hereby acknowledge that I/We are required by law to be responsible for any conduct that violates laws pertaining to the sale of alcoholic beverages, and that both parties are responsible for any violations of the other if the F-2 permit is issued jointly. I/We further depose and say the applicant would be the proper holder of the F-2 permit and that the F-2 permit holder will comply with all applicable statutes and administrative rules. ___________________________________________ (Signature and Title of Applicant) ___________________________________________ (Print Name of Applicant) _______________________________________________________ (Signature of D-3, D-4, or D-5 Permit Holder if to be issued jointly) _______________________________________________________ (Print Name of D Permit Holder, if applicable) Sworn to before me and subscribed in my presence this ________ day of ________________________________, 20_______. _____________________________________________________ (Notary Public) (Notary Expiration) _____________________________________________________ (Notary - Please Print Name or Affix Seal/Stamp) EOE/ADA SERVICE PROVIDER PAGE 2 FOR TTY USERS DIAL ORS 1-800-750-0750 American LegalNet, Inc. www.FormsWorkFlow.com GENERAL INSTRUCTIONS FOR FILING F-2 APPLICATION The F-2 permit is for a function sponsored by a nonprofit organization organized for a charitable, cultural, fraternal or educational purpose, to sell beer or intoxicating liquor by the individual drink, at a place where the sale of beer or intoxicating liquor on that day is otherwise permitted by law. The applicant-organization shall not be affiliated with the holder of any permit other than a D-4 permit. After 1 a.m. an F-2 permit is effective for not more than forty-eight (48) consecutive hours, and no sales can be made No more than two F-2 permits can be issued to the same applicant in one calendar year. IF THE FUNCTION IS TO BE HELD ON SUNDAY, IT MAY BE HELD ONLY IN ACCORDANCE WITH THE RESULTS OF AND UNDER THE RESTRICTIONS OF A LOCAL OPTION ELECTION HELD PURSUANT TO OHIO REVISED CODE SECTION 4301.351. If an applicant wishes the holder of a D-3, D-4 or D-5 permit to conduct the sale of beer and intoxicating liquor at the event, the applicant may request that the permit be issued jointly to itself and the D-3, D-4 or D-5 holder. If the F-2 is issued jointly, both the applicant and the D holder will be held responsible for any violation of the law pertaining to the sale of alcoholic beverages committed by either. ALL DOCUMENTS MUST BE IN THE ORGANIZATION AND PERMIT HOLDER'S NAME. The Division will also consider the past activities of the applicant organization and of any joint D-3, D-4 or D-5 holder while operating under other F-2 permits and the applied for location. APPLICATION WILL NOT BE ACCEPTED OR MAY NOT BE ISSUED WITHOUT THE FOLLOWING REQUIRED DOCUMENTS 1. Filing Fee. Make check payable to the Division of Liquor Control. Please do not mail cash. a. $150.00 Fee for an F-2 issued to applicant alone. b. $160.00 Fee if issued jointly with D-3, D-4 or D-5 holder. 2. Division of Liquor Control Form DLC 4221, (Tenancy/Police Notification) 3. Copy of Diagram of permit premises, denoting areas where alcoholic beverages will be consumed. 4. If the event is on the premises of a retail permit holder you must submit a notarized affidavit, signed by an officer/owner of the retail permit, stating they will not utilize their permit privileges at the same time and place as the temporary event. 5. If there will be any type of street/alley closure, you must submit written approval from authority in control. 6. You may have to submit proper documentation from the Secretary of State proving not for profit status. WARNINGS Applicant must be at least twenty-one (21) years of age. Section 4301.24 Of Ohio Revised Code prohibits any manufacturer or wholesale distributor from aiding or assisting any retail permit holder by gift or loan of any money or property of any description or other valuable thing; and it prohibits any retail permit holder from accepting same. THIS MEANS A WHOLESALE DISTRIBUTOR MAY NOT AID THE PERMIT HOLDER IN ANY WAY, EITHER FINANCIALLY OR BY ADVERTISING THE FUNCTION COVERED BY THIS APPLICATION; AND THE PERMIT HOLDER MAY NOT ACCEPT SUCH ASSISTANCE FROM THE WHOLESALE DISTRIBUTOR. An "F-2" permit holder must purchase all alcoholic beverages from a wholesale Distributor or Contract Liquor Agency for spirituous liquor. Donation of any alcoholic beverages is prohibited. It is illegal to allow a patron to remove any alcoholic beverage from or to consume it off the premises designated on your permit. No carryout privileges are permitted under an F-2 permit. It is illegal for any person under the age of twenty-one (21) to purchase or consume alcoholic beverages. It is the permit holder's responsibility to obtain proper identification. Page 3 American LegalNet, Inc. www.FormsWorkFlow.com OHIO DEPARTMENT OF COMMERCE DIVISION OF LIQUOR CONTROL 6606 Tussing Road, P.O. Box 4005, Reynoldsburg, Ohio 43068-9005 TENANCY & POLICE NOTIFICATION FORM FOR A TEMPORARY "F2" APPLICATION Section A. (Completed by Applicant): TEMPORARY PERMIT FUNCTION INFORMATION The _________________________________________________________________________________________________________________ (Full Name of Organization [this must be same as what is listed on Application]) will be conducting an event at the location of ________________________________________________________________________________ (Location or Street address where function held [this must be same as what is listed on Application]) and has applied for an "F-2" class temporary liquor permit to allow the sale of beer, wine, mixed beverages and spirituous liquor: beginning _____________________________________ at (Date Function Begins) am pm am pm (Time Function Begins) and ending ____________________________________ at __________________ (Date Function Ends) (Time Function Ends) Section B. (Completed by Property Owner): CONSENT OF REAL PROPERTY OWNER INFORMATION If applicant is owner of real property mark box, and sign below. I/We, being the owner of the realty located at the address mentioned in Section A. above, do hereby acknowledge notification that the Organization listed above will hold a special function on the dates specified by signing below. X____________________________________________________________ _________________________________________________ _________________ (Date) (Print Name of Real Property Owner) (Signed - Real Property Owner) _______________________________________________________________________________________________________________________________ (Telephone Number) (City, State, and Zip Code (Street Address of Real Property Owner) Section C. (Completed by Chief Peace Officer): NOTICE TO CHIEF PEACE OFFICER (City/Township Police, OR County Sheriff) This portion must be signed by the Chief Peace Officer in the municipality or the township where this function will be held indicating that he/she has been notified of the date, time, place and duration of the event. (If the township does not have a Chief Peace Officer, the County Sheriff's Department must be notified accordingly.) I, being the Chief Peace Officer of the City, Township or County where the function listed above in "Section A" will be held, acknowledges that I have received notification that the Organization listed above will hold a special function on the dates specified, by signing below. City Police Twp Police County Sheriff X_________________________________________________________________________________________________________________________________ (Signed) (Title) (Check the box that applies) (Date) __________________________________________________________________ (Print Name) In signing this form, the Chief Peace Officer is merely acknowledging receipt of notification of the event and not giving their approval or consent of the event on behalf of the political subdivision. DLC 4221 EOE/ADA SERVICE PROVIDER Page 4 FOR TTY USERS DIAL ORS 1-800-750-0750 American LegalNet, Inc. www.FormsWorkFlow.com NOTICE TO APPLICANTS FOR "F" OR "F2" PERMIT DIAGRAM OF PERMIT PREMISES FOR "F or F2" PERMIT THIS DOCUMENT MUST BE COMPLETED IN ORDER TO OBTAIN YOUR TEMPORARY PERMIT Section 4301.62 ("open container statute") prohibits anyone from possessing an open container of any alcoholic beverage outside of the area defined as permit premises. Whoever violates this statute is guilty of a MISDEMEANOR. Any alcoholic beverage must be both sold and consumed within the defined permit premises. It is now required that every applicant for an F or F2 permit submit with the application a diagram of the premises where alcoholic beverages will be sold and consumed. If the diagram is not included, the application will be returned to the applicant. The diagram can be submitted in the space provided below or on a separate sheet, and signed by the person who prepared the diagram or the applicant. FOR EVENTS HELD INDOORS: Diagram must identify the room(s) and/or building in which the alcoholic beverages will be sold and consumed. FOR EVENTS HELD ENTIRELY or PARTIALLY OUTDOORS: Diagram must show shape and measured dimensions of the area to be used. Location of barriers must be shown, and an explanation of the type of barriers given (e.g. chain link fence, snow fence, brick wall, rope, etc.) which will separate permit premises from other areas which are not permit premises. DIAGRAM MUST APPEAR IN THE SPACE BELOW, OR ON A SEPARATE SHEET NOTE: APPLICANT MUST SIGN THE ACTUAL SHEET THE DIAGRAM IS ON Signature of Person who prepared diagram Page 5 American LegalNet, Inc. www.FormsWorkFlow.com