Notice Of Payment Of Default
Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Notice Of Payment Of Default Form. This is a Texas form and can be use in Alcoholic Beverage Commission Statewide.
Loading PDF...
Tags: Notice Of Payment Of Default, C-803, Texas Statewide, Alcoholic Beverage Commission
FORM C-803 (5/2009)
NOTICE OF PAYMENT OF DEFAULT
Note: All sections of this form must be filled out completely with correct information & signature of representative.
PERMIT NUMBER:
DATE:
PLEASE (X) THE FOLLOWING DELIVERY PERIOD: 1 – 15
OR 16 – 31
TRADENAME:
OWNER:
LOCATION ADDRESS:
DATE OF PAYMENT:
AMOUNT PAID:
NOTE: The delinquent amount paid must
match the AMOUNT UNPAID reported on
the Notice of Default in order to process
the payment.
Name of Wholesaler or Local Distributor Permittee
Permit Number
Address
Representative’s Signature
Title
NOTICE TO RETAILER, MIXED BEVERAGE OR PRIVATE CLUB PERMITTEE:
This notice of payment does not constitute a release from the delinquent list. You may not purchase alcoholic
beverages until your permit/license number has been released from the delinquent list.
The original of this notice must be submitted to T.A.B.C. by one of the following options; email
credit.law@tabc.state.tx.us, fax 512-206-3329 or at the address listed below.
Texas Alcoholic Beverage Commission
P.O. Box 13127
Austin, TX 78711
A copy of this notice may be mailed to the retailer, Mixed Beverage or Private Club Permittee being released.
American LegalNet, Inc.
www.FormsWorkFlow.com
