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Dallas Liquor License Application

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                                        INDIVIDUAL, PARTNERSHIP, OR OTHER OWNERSHIP SPECIFIC INFORMATION

FederallD#:                                     I               I—I                  I        I                                       I        I          I            I                  I                I

Social Security#                                        II               I-iI-I                                                                                   III

Owner of Business (Name):
Owner Home Address:
                                                                                                                                      Street Address                                                                                                                                                       ApartmentJUnit#


                                                                                                                                              City                                                                                                                                                         State                                                Zip Code

Owner Mailing Address:
(If different   from Home             Address)                                                                                        Street       Address                                                                                                                                                 Suite/Unit#


                                                                                                                                              CJç                                                                                                                                                          State                                                Zip Code
Home Phone:               (                                                                                                                             Owner D.O.B.
Mobile Phone(_j                                                                                                                                         Driver’s License#                                                 I                       I               I               I               I I                  I           I           I                State:
1
Email
iiress:                           I                                          I                                                                      I                  I              I           I             I I               I                                                       I        I                                                   I        I      I       I
                                                        (CO-OWNER INFORMATION                                                                                 -   USE ADDITIONAL PAPER, AS NEEDED)
Co-Owner Federal ID#:                                            I       I—I                              I               111111111

Co-Owner Social Security#                               I            i           I                I           -           I               I              I—I                              I           I         I
Co-Owner of Business
(Name):




Co-Owner Home Address:
                                                                                                                                  Street Address                                                                                                                                                           Apartment/Un/Nt

                                                                                                                                              City                                                                                                                                                         State                                            Zip Code

Co-Owner Mailing Address:
(If different   from Home             Address)                                                                                        Street       Address                                                                                                                                                 Suite/Unit#

                                                                                                                                              City                                                                                                                                                         State                                            Zip Code
Home Phone:           (                     )                                                                                                           Owner D.O.B.
Mobile Phone:         (                                                                                                                                 Driver’s License#                                             I                   I   I               I               I               I        I                                                    State:
                                                                                                                                                                                                                                                                                                                   I           I           I

                              I         I           I       I        I   I                I           I               I           I           I I             I    I              I

Name:
Home Address:
                                                                                         Street Address
                                                                                                                                                                                                                                                                                                                                                   Apartment/Uriit#




                                                                                                  City                                                                                                                                                                                                     State                                                    Zip Code
Business
Phone:                                                                                                                                                  Owner DO. B.
Home Phone:           (                     )                                                                                                           Driver’s License#                                       I     I               I       I           I                                                                                                State:
                                                                                                                                                                                                                                                                          I                   I                I               I           I
Mobile Phone:         (                                                                                                                                 Pager#:

EmailAddress:                     I    I  I          I   I                                                        I           I           I I                                 I               I                 I I           I                       I               I               I            I I                     I                       I        I              I
     Your signature on this application will constitute an admission that you are now or will be. when and if license is issued, the owner of the business listed on this
     application, a co-owner or partner whose partnership owns or will own the business listed, or a corporate office of a corporation which owns or wilt own the business
     listed and that you have read and understand the application form and Chapter 6 of the Dallas City Code

     Owner Signature:                                                                                                                                                                                                                                     Date:____/                                                                   /
     Co-Owner Signature:__________________________________________________                                                                                                                                                                                Date:                                            /                           /
                                                                                                                                                                           City of Dallas Beer License, Beer and Wine Permit and/or Liquor Permit
                                                                                                                                                                                                                    Issue: 06/01/2006
                                                   NOTICES AND INSTRUCTIONS

CITY BEER LICENSE, BEER AND WINE PERMIT AND/OR LIQUOR PERMIT APPLICATION PROCEDURES

STEP 1.      Applications must be turned into the office listed below:

                    Office of Financial Services / Special Collections Division
                    1500 Manila St., Room 2DS, Dallas, TX 75201
                    (214) 670-3438
                    (Mailing Address: P0 Box 139076, Dallas, TX 75313-9076)

With your application you must pay the applicable fee for the type of Beer License or Beer and Wine Permit and/or Liquor Permit
for your establishment. All Beer Licenses, Beer and Wine Permits and/or Liquor Permit fees are non-refundable and non-
transferable.

STEP 2.      Office of Financial Services / Special Collections Division

The Special Collections Division will review the application and license and/or permit payment(s) to determine if it meets all
provisions of the Dallas City Code, Chapter 6 Alcoholic Beverages. If the application is incomplete or the payment incorrect, the
Special Collections Division will notify the applicant with information of what must be provided. (NOTE: It is a violation of
Chapter 6 of the Dallas City Code to operate a Beer, Beer and Wine and/or Liquor establishment without obtaining the
appropriate licenses and/or permits from the aty of Dallas prior to operation).

RENEWALS

Renewals are processed in the same manner as a new application. You should submit your renewal application at least thirty (30)
days before it expires. No temporary license will be issued while your application is being processed. For your convenience, a
renewal application will be sent to you, populated with the current information in our system. You will be required to complete the
renewal application and pay all applicable licensing and/or permit fees. If there has been an ownership change for this
establishment, please complete a new application. Applications can be downloaded from our website at

ELECTRONIC NOTIFICATIONS:

[j I would like to receive all future communications, renewal notifications, billing statements, and any and all other
correspondence regarding my account, via email. By checking this box, I acknowledge and accept the receipt of “Electronic
Notifications” as the primary source of communications for my account(s) with the City of Dallas, Special Collections Division. I
further understand that it is my responsibility to notify the Special Collections Division of any changes in my email address or data
contained in this application and that my failure to properly notify the City of Dallas could result in me not receiving electronic
notifications and could result in additional fees, penalties or interest assessments being levied against my account(s). My current
email address is:

    (Use as many boxes as needed. One letter or number per box, only)

                                I                                  I                                   I
                I                                  I          I                  I I                         I               I
Change notifications must be in writing and addressed to the:

    Office of Financial Services / Special Collections Division
    P0 Box 139076,
    Dallas, TX 753 13-9076

[1 I do not wish to receive communications, via email, regarding my account (renewal notifications, billing statements, and any
    and all other correspondence).

    please note: you can change to email notifications by writing to us, at the above address, and providing your email
     information to us at any timed.



                                                                       City of Dallas Beer License, Beer and Wine Permit and/or Liquor Permit
                                                                                                                Issue: 06/01/2006

				
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