LIQ 129 Added Activities Beer Wine Grocery Stores 12 29

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					                                        Licensing and Regulation
                                        PO Box 43098               Trade Name
                                        Olympia WA 98504-3098
                                        Phone – (360) 664-1600     License Number
                                        Fax – (360) 753-2710
                                        www.liq.wa.gov             UBI Number



                ADDED ACTIVITIES FOR BEER/WINE GROCERY STORES

Do you want any of the following activities?

 Beer or Wine Sampling             Yes        No
 Cooking Classes                   Yes        No

Note: To qualify for the above activities, you must also apply for the Beer/Wine Tasting Endorsement.
Delivery of Beer or Wine          Yes         No
Internet Sales                    Yes         No
If you have answered YES to any of the activities above, please answer the appropriate questions listed
below. If you have answered NO to all of the activities, your signature and date is all that is required.

1 Where will the sale of your products (including alcohol) take place?


2 How do you plan to deliver the product?




3 How will you be certain only people 21 or older make the purchase and receive the delivery?


  If you plan to sell out of Washington, how will you determine the age of the buyer and receiver and how
4 will it be delivered?



OTHER


CENTRAL WAREHOUSING FOR WINE AND/OR SPIRITS                          Yes            No
If YES, please submit a completed Warehouse Registration form and the required documents.




Signature (Sole Proprietor, Partner, Corporate Officer, LLC Member/Manager)              Date




LIQ 129 12/11

				
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