Application By Limited Winery For Permitted Fruits Permit
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Application By Limited Winery For Permitted Fruits Permit Form. This is a Pennsylvania form and can be use in Liquor Control Board Statewide.
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Tags: Application By Limited Winery For Permitted Fruits Permit, PLCB-2209, Pennsylvania Statewide, Liquor Control Board
PLCB-2209 9/00 I
APPLICATION BY LIMITED WINERY
FOR PERMITTED FRUITS PERMIT
COMMONWEALTH OF PENNSYLVANIA
PENNSYLVANIA
LIQUOR CONTROL BOARD
BUREAU OF LICENSING
13C
(SEE INSTRUCTIONS ON REVERSE)
Approval is hereby requested for a Limited Winery to import and use permitted fruit in the current year’s production, for the license
period expiring December 31, 20 _____ .
11. NAME OF LICENSEE
LID NO.
LICENSE NO.
CONTACT PHONE NO.
12. TRADE NAME (IF ANY)
(
13. ADDRESS OF PREMISES
(STREET, RURAL ROUTE, P.O. BOX NO.)
14.
)
(POST OFFICE)
(STATE)
(ZIP)
RESOLUTION (CORPORATIONS ONLY)
At a regular or special meeting held on _________________________________________ , 20 _____ by the applicant
corporation, it was resolved that said application be filed with the Pennsylvania Liquor Control Board, and that
________________________________________ and/or _______________________________________ is/are hereby
(NAME OF OFFICER/TITLE)
(NAME OF OFFICER/TITLE)
authorized to execute said application, and any other papers required by the Board.
15.
A permitted fruits permit allows limited winery to
*use fruit grown, or juice derived from fruit grown, within 350 miles of the limited winery.
*use up to 25% permitted fruit in the current year’s production.
*produce no more than 200,000 gallons of wine, wine coolers, and alcoholic ciders per year.
I have read and understood the foregoing statements and I affirm and attest, subject to the penalties provided by 18 Pa. C.S. §4904 and 47
P.S. §5-504(b), that the answers provided on this application are true and complete to the best of my knowledge and belief.
SIGNATURE
TITLE
NAME OF ATTORNEY REPRESENTING YOU IN THIS MATTER, IF ANY
HOME ADDRESS
PHONE
ADDRESS
(
SIGNATURE
HOME ADDRESS
)
PHONE
TITLE
PHONE
(
(
)
DATE SIGNED
)
DO NOT WRITE BELOW THIS LINE
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INSTRUCTIONS
This form is to be submitted by limited wineries to apply for a new Permitted Fruits Permit. All questions must be
answered, and the form must be dated and signed. A $50.00 permit fee must be submitted with the application.
This exceptional use permit is an annual permit.
INFORMATION
IF YOU REQUIRE ASSISTANCE IN COMPLETING THE APPLICATION PACKET, CALL THE LICENSING
INFORMATION CENTER AT (717) 783-8250.
SEND THE APPLICATION PACKET TO: PENNSYLVANIA LIQUOR CONTROL BOARD, BUREAU OF
LICENSING, P.O. BOX 8940, HARRISBURG, PA 17105-8940.
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