Form C-717 (03/2017) OVERVIEW TO REQUEST FOR PAYMENT AGREEMENT Section 5.12 of the Alcoholic Beverage Code states, in part: "The Commission or Administrator may develop a procedure under which the Commission or Administrator, or the designee of either, may negotiate the repayment of debts owed the Commission, including fees and delinquent taxes." The following criteria and qualifications have been developed: CRITERIA 1. 2. If tax security in place, the permittee's delinquency must exceed the available amount, or The permittee must be exempt from bonding requirements. QUALIFICATIONS 3. 4. The permittee must apply to at least two different lending institutions, located in the State of Texas, for a loan to repay the liability, and Notarized copies of the loan applications, and the loan refusal letters, must be presented. TERMS OF REPAYMENT - IF REQUEST APPROVED 5. 6. 7. 25% down payment required. 75% balance paid in not more than six installments, one each due 30 days, 60 days, 90 days, 120 days, 150 days, and 180 days from the date of first payment. Forfeiture of exemption from bonding requirements, if currently bond exempt. CONSIDERATION 8. 9. 10. No Order of Summary Suspension will be issued. Individual liability to secure repayment of the debt. Written Payment Agreement Must be Place. The above points, complete with explanations, have been presented to and discussed with the permittee and the individual named below by the TABC representative named below. All points and issues raised during the presentation have been clarified to the mutual satisfaction of all parties in attendance. Permittee Name d/b/a Trade Name Permit No. Permittee Representative - Title TABC Representative - Title Permittee Representative Signature TABC Representative Signature Date Date American LegalNet, Inc. www.FormsWorkFlow.com American LegalNet, Inc. www.FormsWorkFlow.com