Licensing and Regulatory Services PO Box 43085 Olympia WA 98504-0385 360/664-1617 www.lcb.wa.gov For Office Use Only Date Check No. Amount Rec'd Rec'd By 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 and Cannabis Board's customer service desk if you have any questions, at (360) 664-1600 Business Information Current Liquor License Number Name of Licensee Business Mailing Address Street Address/Route/PO Box City State Zip Code Type of License Contact Phone No. License Information 1. Type of license currently held: Airport terminal Publicly owned civic center Privately owned facility open to the public Common carrier 1/4 of annual license fee each $11 each $22 each $6 each x *Fee each $ 2. Number of duplicates = 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 App for Duplicate Liq. Lic. 7/15 American LegalNet, Inc. www.FormsWorkFlow.com