All statutory and rule references mentioned in this application refer to and can be found in the Texas Alcoholic Beverage. Code or Rules located on our website.
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Page 1 of 5 Form L-ON (/202) ON-PREMISE PREQUALIFICATION PACKET L-ON (/202)Submit this packet to t he proper governmental entities to obtain certification for the type of license/pe rmit for which you are applying as required by Sections 11.37, 11. 39, 11.46( b) , 61.37, 61.38 , 61.42 and Rule §33.13 Contact your local TABC office to verify requirements of Section s 11.391 and 61.381 as you may be required to post a sign at your proposed location 60 -days prior to the issuance of your license/permit. All statutory and rule references mentioned in this application refer to and can be found in the Texas Alcoholic Beverage Code or Rules located on our website. www.tabc.texas.gov/laws/code_and_rules.asp LOCATION INFORMATION 1.Application for: Original Add Late Hours Only License/Permit Number Reinstatement Reinstatement and Change of Trade Name License/Permit Number Change of Location Change of Location and Trade Name License/Permit Numbe r 2.Type of On -Premise License/Permit BG Wine and Beer Retailer™s Permit LB Mixed Beverage Late Hours Permit BE Beer Retail Dealer™s On -Premise License MI Miniba r Permit BL Retail Dealer™s On -Premise Late Hours License CB Caterer™s Permit BP Brewpub License FB Food and Beverage Certificate V Wine & Beer Retailer™s Permit f or Excursion Boats PE Beverage Cartage Permit MB Mixed Beverage Permit RM Mixed Beverage Restaurant Permit with FB O Private Carrier™s Permit ŒBrewpubs (BP) with a BG only E Local Cartage Permit – Wine/Beer retailers ( BG) Only 3.Indicate Primary Business at this Location Restaurant Sporting Arena, Civic Center, Hotel Bar Grocery/Market Sexually Oriented Miscellaneous _________________4.Trade Name of Location (Name of restaurant, bar, store, etc.) 5.Location Address City County State Zip Code 6.Mailing Address City State Zip Code 7.Business Phone No. Alternate Phone No. E-mail Address OWNER INFORMATI ON 8.Type of Owner Individual Corporation Partnership Limited Liability Company City/County/University Other Limited Partnership Joint Venture Limited Liability Partnership Trust 9.Owner of Business/Applicant (Name of Corporation, LLC, etc.) PRIMARY CONTACT PERSON The primary contact person should be a person who can answer questions TABC may have about the application. The contact phone and email are mandatory and must be active and updated regularly . If additional information is needed, it will be requested from this contact per son. Delays in responding to requests may delay the processing and approval of your permit/license. 10.Contact Person: Relation to Business: Phone (mandatory) : Email (mandatory) : TABC DATESTAMP
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Page 2 of 5 Form L-ON (/202) 11.Are you, the applicant , a veteran -owned business? Yes No 12. Are you, the appli cant , a Historically Underutilized Business (HUB)? Yes No 13.As indicated on the chart, enter the individuals that pertain to your business type: (For additional space, use Form L -OIC) Individual/Individual Owner Limited Liability Company/All Officers or Managers Partnership/All Partners Joint Venture/Venturers Limited Partnership/All General Partners Trust/Trustee(s) Corporation/All Officers City, County, University/Official Last Name First Name MI Title Last Name First Name MI Title Last Name First Name MI Title MEASUREMENT INFORMATION Section 109.31 et seq . 14.Will your business be located within 300 feet of a church or public hospital? Yes No NOTE: For churches or public hospitals mea sure from front door to front door, along the property lines of the street fronts and in a direct line across intersections. 15. Will your business be located within 300 feet of any private/public school, day care or child care facility ? Yes No If fiYES,fl are the facilities located on different floors or stories of the building? Yes No NOTE: NOTE: NOTE: For private/public schools, day care centers and child care facilities , mea sure in a direct line from the nearest property line of the school, day care center or child care facility to the nearest property line of the place of business, and in a direct lin e across intersections. For multistory building: businesses may be within 300 feet of a day care center or child care facility as long as the facilities are located on different floors of the building. If located on or above the fifth story of a multistory building: measure in a direct line from the property line of the priva te/p ublic school to property line of your place of business in a direct line across intersections vertically up the building at the pro perty line to the base of the floor on which your business is located. 16. Will your business be located within 1,000 feet of a private school? Yes No 17. Will your business be located within 1,000 feet of a public school? Yes No 60-DAY SIGN 18. If required under Section 11.391 and 61.381, provide exact date the required sign was posted at the location. Exact Date (MM/DD/YYYY) ALL APPLICANTS 19.IF YOUR LOCATION IS NOT WITHIN THE CITY LIMITS, CHECK HERE I, the applicant, have confirmed I am not located in the city limits of any city , therefore , city certifications are not required. COMPLETE THE FOLLOWING CHECKLIST BEF ORE SUBMITTING YOUR APPLICATION Per Sec. 102.01, a tied house is defined as any overlapping ownership between those engaged in the alcoholic beverage industry at different levels of the three -tier system. No person having an interest in a permit issued by TABC may secure or hold, directly or indirectly, an ownership interest in a business on a different level. All required forms have been c ompleted. Yes No I have reviewed all forms to ensure they are complete. Yes No I have obtained all required local and state certifications (pages 3 -5). Yes No All application packets have been notarized. Yes No Phone numbers and email address for contact p erson are up to date. Yes No All additional documentation as required b y the application packets is attached . Yes No If required, out of state criminal history checks are attached (PHS #7). Yes No N/A Certification of publication in lo cal newspaper has been completed (page 5 ). Yes No N/A A copy of the newspaper publication is attached (page 5 ). Yes No N/A
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Page 3 of 5 Form L-ON (/202) WARNING AND SIGNATURE IF APPLICANT IS SHOWN AS: WHO MUST SIGN: Proprietorship Individual Owner Partnership Partner Corporation Officer Limited Partnership General Partner Limited Liability Partnership General Partner Limited Liability Company Officer/Manager WARNI NG: Section 101.69 of the Texas Alcoholic Beverage Code states: fi–a person who knowingly makes a false statement or false representation in an application for a permit or license or in a statement, report, or other instrument to be filed with the c ommissi on and required to be sworn commits an offense punishable by imprisonment in the Texas Department of Criminal Justice for not less than 2 nor more than 10 years.fl I, UNDER PENALTY OF LAW, HEREBY SWEAR THAT I HAVE READ ALL THE INFORMATION PROVIDED IN THE A PPLICATION AND ANY ATTACHMENTS AND THE IN FORMATION IS TRUE AND CORRECT. I ALSO UNDERSTAND AN Y FALSE STATEMENT OR REPRESENTATION IN THIS APPLICATION CAN R ESULT IN MY APPLICATION BEING DE NIED AND/OR CRIMINAL CHARGES FILED AGAINS T ME. I ALSO AUTHORI ZE THE TEX AS ALCOHOLIC BEVERAG E COMMISSION TO USE ALL LEGAL MEANS TO VERIFY THE INFORM ATION PROVIDED. PRINT NAME SIGN HERE TITLE Before me, the undersigned authority, on this day of , 20 , the person whose name is signed to the foregoing application personally appeared and, duly sworn by me, states under oath that he or she has read the said application and that all the facts therein set forth are true and correct . SIGN HERE NOTARY PUBLIC S E A L CERTIFICATE OF CITY SECRETARY FOR MB, & BE Section 11.37 & 61.37 Not later than the 30th day after the date a prospective applicant for a license or permit requests certification, the city s ecretary or clerk s hall certify whether the location or address given in the request is in a wet area and whether the sale of alcoholic beverages for which the license or permit is sought is prohibited by ordinance. I hereby certify on this day of , 20 , that the location for which the license/permit is sought is inside the boundaries of this city or town, in a fiwetfl area for such license/permit, and not prohibited by charter or ordinance in reference to the sale of such alcoholic beverages. MB BG legal sale of beer/wine (17%) on-premise AFTER Sept. 1, 1999legal sale of beer/wine (14%) on-premise BEFORE Sept. 1, 1999 BE Beer Retail Dealer™s On-Premise License I hereby refuse on this ______ day of _______________, 20____ to certify this location. SIGN HERE , TEXAS City Secre tary/Clerk City S E A L
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Page 4 of 5 Form L-ON (/202) CERTIFICATE OF CITY SECRETARY FOR LATE HOURS LICENSE/PERMIT LB & BL Chapters 29 & 70 et seq . I hereby certify on this day of , 20 , that one of the below is correct : The governing body of this city has by ordinance authorized the sale of mixed beverages between midnight and 2:00 A.M.; or The governing body of this city has by ordinance authorized the sale of beer between midnight and A.M.; or The population of the city or county where premises are located was 500,000 or more according to the 22 nd Decennial Census of the United States as released by the Bureau of the Census on March 12, 2001; or The population of the city or county where premises are located was 800 ,000 or more according to the last Federal Census (2010). OR I hereby refuse on this ______ day of _______________, 20____ to certify this location. SIGN HERE , TEXAS City Secretary/Clerk City S E A L CERTIFICATE OF COUNTY CLERK FOR MB, BG & BE Section 11.37 & 61.37 Not later than the 30th day after the date a prospective applicant for a license or permit requests certification, the county clerk shall certify whether the location or address given in the request is in a wet area and whether the sale of alcoholic beverages for which the license o r permit is sought is prohibited by order. I hereby certify on this day of , 20 , that the location for which the license/permit is sought is in a fiwetfl area and is not prohibited by any valid order of the Commissioner™s Court . MBRM BG Mixed Beverage Permit Mixed Beverage Restaurant Permit with Food and Beverage Certificate Wine and Beer Retailer™s Permit legal sale of beer/wine (17%) on-premise AFTER Sept. 1, 1999 legal sale of beer/wine (14%) on-premise BEFORE Sept. 1, 1999 BE Beer Retail Dealer™s On-Premise License OR I hereby refuse o n this ______ day of _______________, 20____ to certify this location. SIGN HERE COUNTY County Clerk S E A L
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Page 5 of 5 Form L-ON (/202) CERTIFICATE OF COUNTY CLERK FOR LATE HOURS LICENSE /PERMIT LB & BL Chapters 29 & 70 et seq I hereby certify on this day of , 20 , that one of the below are correct: The Commissioner™s Court of the county has by order authorized the sale of mixed beverages between midnight and 2:00 A.M.; or The Commissioner™s Court of the county has by order authorized the sale of beer between midnight and A.M.; or The population of the city or county where premises are located was 500,000 or more according to the 22 nd Decennial Census of the United States as released by the Bureau of the Census on March 12, 2001; or The population of the city or county where premises are located was 800,000 or more according to the last Federal Census (2010). OR I hereby refuse on this ______ day of _______________, 20____ to certify this location. SIGN HERE COUNTY County Clerk S E A L COMPTROLLER OF PUBLIC ACCOUNTS CERTIFICATE Section 11.46 (b) & 61.42 (b) This is to certify on this day of , 20 , the applicant holds or has applied for and satisfies all legal requirements for the issuance of a Sales Tax Permit under the Limited Sales, Excise and Use Tax Act or the applicant as of this date is not required to hold a Sales Tax Permit . Sales Tax Permit Number Outlet Number Print Name of Comptroller Employee Print Title of Comptroller Employee SIGN HERE FIELD OFFICE S E A L PUBLISHER™S AFFIDAVIT FOR MB, LB, RM, BP , BG, BE, BL & V Sect ion 11.39 and 61.38 Name of newspaper ATTACH PRINTED COPY OF THE NOTICE HERE to see example City, County Date s notice published in da ily/weekly newspaper (MM/DD/YYYY ) Publisher or designee certifies attached notice was published in newspaper stated on dates shown . Signature of publisher or designee Sworn to and subscribed before me on t his date (MM/DD/YYYY) Signature of Notary Public S E A L
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