Application For Out Of State Wine Only Package Store Permit
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Application For Out Of State Wine Only Package Store Permit Form. This is a Texas form and can be use in Alcoholic Beverage Commission Statewide.
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Tags: Application For Out Of State Wine Only Package Store Permit, L-108, Texas Statewide, Alcoholic Beverage Commission
A P P L I C A T I O N F O R O U T - O F -S T A T E W I N E O N L Y
PACKAGE STORE PERMIT
FORM L-108 (8/2009)
ISSUE
DATE
SURCHARGE
$150
TABC USE
ONLY
FEE
LATE FEE
(RENEWAL ONLY)
$214
1A. APPLICATION FILED FOR:
Q OUT-OF-STATE WINE ONLY PACKAGE STORE PERMIT –
OUT-OF-STATE RETAILER
B. APPLICATION IS FOR:
Original
Renewal
Renewal Change
Registry No.
Change of
C. If renewal or change, enter permit no(s).
2A. Applicant is:
Corporation
Partnership
Limited Liability Company
Limited Partnership
FOR ALL RETAILERS
Individual
Joint Venture
Limited Liability Partnership
Other:
Trust
B. Indicate primary business at this location:
06 - Grocery/Market
07 – Liquor/Wine Store
05 – Miscellaneous (ex: Internet Sales):
C. Does the applicant own the land and building at the proposed licensed location?
If “NO,” please complete form L-108-OP with owner of premise information.
C.
YES NO
INSTRUCTIONS: All applicants complete questions 3-6. Individual Business Owners ALSO complete question 7.
3. Trade Name of Business
4. Location Address
City
County
State
ZIP Code (9 digits)
TX
5. Mailing Address
City
State
ZIP Code (9 digits)
-
6. Area Code + Business
Phone No.
FOR INDIVIDUAL
(
)
-
Area Code + Alternate
Phone No.
(
)
7. Social Security Number of Individual
-
Applicant’s E-Mail Address
Issuing State/Driver’s License Number
-
Date of Birth (mm/dd/yyyy)
/
/
Full Legal Name of Individual (Last, First, Middle)
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