For Validation Only Licensing and Regulation 3000 Pacific Ave SE PO Box 43098 Olympia WA 98504-3098 Phone: 360-664-1600 Select Option 1, then Option 2 lcb.wa.gov Application for Farmers Market Authorization to Allow the Sale of Bottled Wine, Beer or Spirits This application is for a qualified Washington State farmers market to allow eligible in-state wineries, breweries or distilleries to sell bottled wine, beer or spirits of their own production at the farmers market. There is no fee for this authorization. To qualify for this authorization, farmers markets must meet all of the requirements listed on page two of this application. A farmers market must receive authorization from the Washington State Liquor and Cannabis Board (WSLCB) before an eligible winery, brewery or distillery will be permitted to sell bottled wine, beer or spirits at the market. An eligible winery, brewery or distillery is one that has been issued the appropriate license endorsement by the WSLCB. A map of the farmers market showing all booths, stalls, or other designated locations at which an approved winery, brewery or distillery may sell bottled wine, beer or spirits must accompany this application. For more information, please visit lcb.wa.gov/content/farmers-markets. If you have any questions, please contact the Licensing Division at 360-664-1600, select Menu Option 1, and then Option 2. Applying for authorization to allow: The sale of bottled wine by Washington wineries The sale of bottled beer by Washington breweries The sale of bottled spirits by Washington distilleries Sampling of Wine or Beer only, sampling of spirits is prohibited Name of Farmers Market Location Address Mailing Address Name of Market Manager(s) Email Address Contact Telephone Number(s) Note: The person(s) listed above will be the person(s) the Liquor and Cannabis Board contacts to complete this application and will serve as an on-site contact for the WSLCB. You must inform the WSLCB of any changes in your market manager(s) or contact information. LIQ 127- 10/16 *LCB LIQ127* American LegalNet, Inc. www.FormsWorkFlow.com Farmers Market Requirements To qualify for this authorization, I certify under penalty of perjury that the farmers market submitting this application meets all of the following requirements as listed in RCWs 66.24.170, 66.24.240, 66.24.244, 66.24.140 and 66.24.145: The market is an entity that sponsors a regular assembly of vendors at a defined location, for the purpose of promoting the sale of agricultural products grown or produced in Washington directly to consumers. The market has at least five participating vendors who are farmers selling their own agricultural products. A "farmer" means a person who sells agricultural products raised on land he/she owns or leases in this state, or in a county that borders the state. The total combined gross annual sales of vendors who are farmers at this market exceed the total combined gross annual sales of vendors who are processors or resellers. o A "processor" means a person who sells processed food personally prepared on land he or she owns or leases in this state, or in a county that borders the state. o A "reseller" means a person who buys agricultural products from a farmer and resells the products directly to consumers. The total combined gross annual sales of vendors who are farmers, processors, or resellers at this market exceed the total combined gross annual sales of all other vendors. OR The farmers market qualifies for the purposes of sampling as the total combined gross annual sales of vendors at the market are $1 million or more. The market does not have vendors that sell imported or secondhand items. The market does not have vendors who are franchisees. I understand that these are continuing requirements and that failure to meet any of these requirements at any time may result in the revocation of this authorization by the WSLCB. Signature Date Print Name Title LIQ 127- 10/16 American LegalNet, Inc. www.FormsWorkFlow.com