For Validation Only Liquor Control Board Licensing and Regulation 3000 Pacific Ave SE PO Box 43098 Olympia WA 98504-3098 www.liq.wa.gov Application for Farmers Market to Allow the Sale of Bottled Wine and/or Beer This application is for a qualified Washington State farmers market to allow eligible in-state wineries and/or breweries to sell bottled wine and beer at their market. There is no fee for this application. To qualify for this certification, farmers markets must meet the requirements outlined on the back of this application. A farmers market must receive authorization from the Liquor Control Board before the agency will permit a winery or brewery to sell wine at your market. This application must accompany a map of the farmers market showing all booths, stalls, or other designated locations at which an approved winery or brewery may sell bottled wine or beer. Once approved, this endorsement allows you to have approved in-state wineries and breweries sell bottled wine or beer only at your market. No tastings or samplings are allowed. Please see the fact sheet “Selling Wine and Beer at Farmers Markets” for more information. If you have any questions, please contact the Liquor Control Board’s Licensing Division at 360-664-1600, option 4. Applying to allow: The sale of bottled wine by Washington wineries The sale of bottled beer by Washington breweries Both Name of Farmers Market Location Address Mailing Address Name of Market Manager(s) Contact Telephone Number(s) Note: The person(s) listed above will be the person(s) the Liquor Control Board contacts to complete this application and will serve as an on-site contact for the Liquor Control Board. You must inform the Liquor Control Board of any changes in your market manager(s) or contact information. LIQ 127-50-6/03 American LegalNet, Inc. www.FormsWorkflow.com FARMERS MARKET REQUIREMENTS I certify under penalty of perjury that the farmers market making this application meets the following qualifications as outlined in: RCW 66.24.170 for the sale of bottled wine, and RCW 66.24.240 and RCW 66.24.244 or the sale of bottled beer. 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. "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. 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. 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. The market does not have vendors that sell imported or secondhand items or who are franchisees. I am aware that these requirements are ongoing requirements, and that the failure to meet any of these requirements may result in the revocation of the Liquor Control Board’s approval to allow wineries and/or breweries to sell bottled wine or beer at my market. Signature Date Print Name Title LIQ 127-50-6/03 American LegalNet, Inc. www.FormsWorkflow.com