Liquor Control Board Licensing and Regulation 3000 Pacific Ave SE PO Box 43098 Olympia WA 98504-3098 Fax: (360) 753-2710 Application for Duplicate Liquor License Complete this application if: You hold a Spirits, Beer, and Wine Restaurant license in a facility with multiple buildings, and you wish to sell liquor from additional sites located on the same property; or You are an Interstate Common Carrier licensee who wishes to sell liquor on additional planes, trains, or vessels under the control of the same licensee. Please call the Liquor Control Board’s customer service desk if you have any questions, at (360) 664-1600 Business Information Current Liquor License Number Type of License Name of Licensee Contact Phone No. Business Mailing Address Street Address/Route/PO Box City State Zip Code License Information 1. Type of license currently held: Airport terminal __________________________________________1/4 of annual license fee each Publicly owned civic center __________________________________________$10 each Privately owned facility open to the public Common carrier 2. ________________________________$20 each ____________________________________________________$5 each Number of duplicates x *Fee each $ = Total amount due $ Please make check payable to the Washington State Liquor Control Board (WSLCB). 3. List additional locations for which duplicate licenses are requested. For Restaurant licenses, list additional room/building names or numbers. For Common Carrier licenses, list names and/or numbers of additional planes, trains or vessels. Please attach additional sheets if more space is needed. Licensee Signature Date LIQ 258-50-7/03 (shared/regsvcs/forms/liq25850 American LegalNet, Inc. www.FormsWorkflow.com