Ohio Department of Commerce - Division of Liquor Control 6606 Tussing Road, P.O. Box 4005, Reynoldsburg, Ohio 43068-9005 Telephone No. (614) 387-7407 - http://www.com.ohio.gov/liqr F-6 PERMIT APPLICATION An F-6 permit may be issued to a nonprofit organization that is exempt from federal income taxation under the "Internal Revenue Code of 1986, "100 Stat.2085, 26 U.S.C.A. 501(c)(3), as amended, to sell wine at an event organized and conducted by, and for the benefit of, the nonprofit organization. No F-6 permit shall be effective for more than seventy-two consecutive hours, and sales of wine under the permit shall be confined to the same hours permitted to the holder of a D-2 permit. The Division shall not issue more than six F-6 permits per calendar year to the same nonprofit organization, (please see Page 2 to reference the entire statute, 4303.206). APPLICATION SHOULD BE FILED 30 DAYS PRIOR TO EVENT THE FEE FOR AN F-6 PERMIT IS $50.00 CAREFULLY READ THE GENERAL INSTRUCTIONS FOR FILING F-6 APPLICATION PROPOSED F-6 PERMIT PREMISES INFORMATION SECTION (A) Full Name of Non-Profit Organization: Street Address (Where Function Will Be Held - BE SPECIFIC): Township (if outside city limits): Zip Code: City: County: Mail and/or Fax Permit and Correspondence To: Name: Street Address: State: Zip Code: City: Phone #: Individual responsible for the compliance with Ohio's liquor laws in conjunction with the sale and consumption of alcoholic beverages: Fax #: Name: Title: Date and Time Function Will Begin: Date Function Begins: Time Function Begins: Date and Time Function Will End: Date Function Ends: Time Function Ends: SECTION (B) am pm am pm APPLICANT/ORGANIZATION'S INFORMATION 1. Submit a copy of the organization's 501(C)(3) designation from the IRS 2. Please provide the following information on the TOP FOUR OFFICERS: Name: Title: Name: Residence Address: Residence Address: Phone: Title: Phone: Name: Title: Name: Residence Address: Residence Address: Phone: Title: Phone: Taxing District FOR OFFICE USE ONLY Reviewer Action: Remarks: Permit Number Receipt # DLC 4257 Rev. 8-2010 American LegalNet, Inc. www.FormsWorkFlow.com (E) Nothing in this chapter or Chapter 4301. of the Revised Code or any rule adopted by the liquor control commission prevents the holder of an F-6 permit from obtaining wine by donation from a manufacturer, supplier, or wholesale distributor of wine or from any person who is not the holder of a permit issued by the division of liquor control. (F) Notwithstanding any contrary provision of section 4301.24 of the Revised Code or of any rule adopted by the liquor control commission, employees of a manufacturer, supplier, or wholesale distributor may assist the holder of an F-6 permit in serving wine at the event for which the permit is issued. (G) The division shall prepare and make available an F-6 permit application form and may require applicants for the permit to provide information necessary for the administration of this section. (H) No F-6 permit shall be effective for more than seventy-two consecutive hours, and sales of wine under the permit shall be confined to the same hours permitted to the holder of a D-2 permit. The division shall not issue more than six F-6 permits per calendar year to the same nonprofit organization. (I) The fee for an F-6 permit is fifty dollars. § 4303.206 F6 permit. (A) The division of liquor control may issue an F-6 permit to a nonprofit organization that is exempt from federal income taxation under the “Internal Revenue Code of 1986,” 100 Stat. 2085, 26 U.S.C.A. 501(c)(3), as amended, to sell wine at an event organized and conducted by, and for the benefit of, the nonprofit organization. (B) An F-6 permit may be issued to a nonprofit organization if the premises of the event for which the F-6 permit is sought is located in a precinct, or at a particular location in a precinct, in which the sale of wine is otherwise permitted by law. The premises of the event for which an F-6 permit is issued shall be clearly defined and sufficiently restricted to allow proper enforcement of the permit by state and local law enforcement officers. If an F-6 permit is issued for all or a portion of the same premises for which another class of permit is issued, that permit holder’s privileges shall be suspended in that portion of the premises in which the F-6 permit is in effect. (C) A holder of an F-6 permit may charge an admission price to attend the event for which the permit is issued, which price includes the consumption of wine or sale of wine by the individual drink. (D) A holder of an F-6 permit may sell wine in its original sealed container by auction at the event for which the permit is issued. SECTION (C) 1. Will the event be organized and conducted by the applicant? If "NO", please explain: YES NO 2. Is the event conducted for the benefit of the applicant? If "NO", please explain: YES NO 3. Is the event being held on the premises of a current holder of a permit issued by the Ohio Division of Liquor Control? If "YES", please complete Section D below, "Consent of Permit Holder". YES NO SECTION (D) - (Complete this Section, only if you answered "YES" to Question 3 above) CONSENT OF PERMIT HOLDER This location is a liquor permit premises, permit number . The permit holder will suspend those permit privileges in the portion of the permit holder premises where the F-6 liquor permit event will take place, as that portion is indicated on the "Diagram of Proposed Permit Premises for F-6 Liquor Permit." _________________________________________________ _______________________________________________ (Signature of general manager or equivalent officer) (Title) _________________________________________________ _______________________________________________ (Print Name) (Day time telephone number) SECTION (E) - (Applicant's Signature & Notarization) State of Ohio, County, ss I, being first duly sworn, according to law, depose and say that the statements (Please Print) and answers made in the foregoing application are true. ___________________________________________________________________________ _____________________ (Title) (Signature of Officer of Organization) (Residence Address) (City) (State) (Zip Code) _______________ (Date) (Area Code & Telephone Number) (To be completed by Notary Public) Sworn to before me and subscribed in my presence this ______________day of _____________________________________, 20 _____________. ________________________________________ (Notary Public) EOE/ADA SERVICE PROVIDER Page 2 _______________ (Notary Expiration) FOR TTY USERS DIAL ORS 1-800-750-0750 American LegalNet, Inc. www.FormsWorkFlow.com TO ENSURE THAT THIS APPLICATION IS PROCESSED AS QUICKLY AS POSSIBLE, PLEASE SUBMIT THE FOLLOWING, ALONG WITH THE COMPLETED, SIGNED, AND NOTARIZED APPLICATION (Section E): $50.00 Permit Fee per event. Please make your check payable to the Division of Liquor Control. Completed and signed "Diagram of Permit Premises for F-6 Liquor Permit", Section (F) below and any attachments. Page 4, Section (G), "Consent of Real Property Owner.." and Section (H), "Notification of Chief Peace Officer" Explanation of any officer's conviction for any felony or misdemeanor, if applicable. Submit a copy of the the organization's 501(C)(3) designation from the IRS SECTION (F) DIAGRAM OF PROPOSED PERMIT PREMISES FOR "F-6" LIQUOR PERMIT Every applicant for an F-6 liquor permit must submit with the application a diagram of the premises where alcoholic beverages will be 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. The diagram must identify the room(s) in which alcoholic beverages will be consumed, and signed by the person who prepared the diagram or the applicant. _________________________________________________________ Signature of person who prepared diagram _________________________________________________________ Print Name Title Phone # 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 "F6" APPLICATION Section G. (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-6" class temporary liquor permit to allow the sale of wine: beginning _____________________________________ (Date Function Begins) at am pm am pm (Time Function Begins) and ending ____________________________________ at __________________ (Date Function Ends) (Time Function Ends) Section H. (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