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Keg Registration Form. This is a Vermont form and can be use in Department Of Liquor Control Statewide.
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Tags: Keg Registration Form, Vermont Statewide, Department Of Liquor Control
VERMONT KEG REGISTRATION FORM
Licensee Name_________________________________________
Doing Business As______________________________________
Address_______________________________________________
Town/City_____________________________________________
Proper proof of identification is a photo
drivers license, Liquor Control photo ID,
valid passport, US military ID or photo
non-driver motor vehicle ID.
PLEASE READ CAREFULLY! Deposit on each keg is $ 25.00. Deposit will not be returned if keg registration label has
been removed or is illegible. KEG MUST BE RETURNED WITHIN 60 DAYS OF PURCHASE. Any person who,
within 60 days of purchase fails to return a keg, as defined in ยง 64 of Title 7, VSA, to the second class licensee from which
the keg was purchased shall be fined not more than $200.00.
KEG TAG#
KEG TAG#
KEG TAG#
KEG TAG#
KEG TAG#
BEER BRAND:
NAME:______________________________________
ADDRESS:
CITY/TOWN:
PURCHASE DATE:
RETURN DATE:
NAME OF EMPLOYEE MAKING SALE
KEG SIZE:
PHONE#:
DATE OF BIRTH:
ID #:
BEER BRAND:
NAME:______________________________________
ADDRESS:
CITY/TOWN:
PURCHASE DATE:
RETURN DATE:
NAME OF EMPLOYEE MAKING SALE
KEG SIZE:
PHONE#:
DATE OF BIRTH:
ID #:
BEER BRAND:
NAME:______________________________________
ADDRESS:
CITY/TOWN:
PURCHASE DATE:
RETURN DATE:
NAME OF EMPLOYEE MAKING SALE
KEG SIZE:
PHONE#:
DATE OF BIRTH:
ID #:
BEER BRAND:
NAME:______________________________________
ADDRESS:
CITY/TOWN:
PURCHASE DATE:
RETURN DATE:
NAME OF EMPLOYEE MAKING SALE
KEG SIZE:
PHONE#:
DATE OF BIRTH:
ID #:
BEER BRAND:
NAME:______________________________________
ADDRESS:
CITY/TOWN:
PURCHASE DATE:
RETURN DATE:
NAME OF EMPLOYEE MAKING SALE
KEG SIZE:
PHONE#:
DATE OF BIRTH:
ID #:
SIGNATURE:
SIGNATURE:
SIGNATURE:
SIGNATURE:
SIGNATURE:
Any person (other than the wholesale dealer) who intentionally removes or defaces the label attached to a keg shall be imprisoned not more than two
years or fined not more than $1,000.00 or both.
LICENSEE MUST RETAIN THIS FORM FOR 90 DAYS AFTER RETURN OF KEG/KEGS
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