Form ABC-209 "Application Withdrawal" - California

What Is Form ABC-209?

This is a legal form that was released by the California Department of Alcoholic Beverage Control - a government authority operating within California. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on July 1, 2019;
  • The latest edition provided by the California Department of Alcoholic Beverage Control;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form ABC-209 by clicking the link below or browse more documents and templates provided by the California Department of Alcoholic Beverage Control.

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Download Form ABC-209 "Application Withdrawal" - California

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Department of Alcoholic Beverage Control
State of California
Gavin Newsom, Governor
APPLICATION WITHDRAWAL
Read instructions on reverse before completing.
DATE OF WITHDRAWAL
PENDING FILE NUMBER
1. APPLICANT(S) NAME(S)
2. COPIES MAILED DATE
3. APPLICANT PREMISES ADDRESS (proposed premises)
4. LICENSE TYPE(S) APPLIED FOR
5. TRANSACTION TYPE
Original
Person to Person Transfer
Double Transfer
Exchange
Premises Transfer
Other
6. TRANSFEROR NAME (if applicable)
7. TRANSFEROR PREMISES ADDRESS (if applicable)
8. REASON FOR WITHDRAWAL
9. REFUND INFORMATION
The undersigned hereby request the Department of Alcoholic Beverage Control to withdraw the above-described
application and to refund or apply the fee as follows if a refund is applicable per Section 23320 B&P.
Make refund payable to the applicant entity(s) as listed on Form ABC-211, Application for ABC License.
Make refund payable to:
I agree to submit documentation to ABC Headquarters within 15 days from the date I sign this withdrawal that the foregoing
person paid the license fees. I understand that failure to submit documentation will result in the refund being made payable to
the entity(s) shown on Form ABC-211, Application for ABC License.
Apply any refundable portion on supplemental application for:
10. MAILING ADDRESS FOR REFUND (Street number and name, city, state, zip code)
11. APPLICANT SIGNATURE
PRINTED NAME
DATE SIGNED
X
12. TRANSFEROR SIGNATURE (If applicable)
PRINTED NAME
DATE SIGNED
X
13. SIGNATURE OF WITNESS
PRINTED NAME
DATE SIGNED
X
ABC USE ONLY
If protested application, District Administrator/District Supervisor must complete this section. Investigation reveals:
Application withdrawn due to protest. Applicant may not refile at this premises for one year (Section 24013.1 B&P Code).
Application withdrawn due to protest against premises. Protests to remain valid at this premises for one
year (Section 24013.2 B&P Code).
Application not withdrawn due to the valid protest(s). Protests not to be carried forward.
DISTRICT ADMINISTRATOR/DISTRICT SUPERVISOR SIGNATURE
DATE SIGNED
Original to HQ Licensing; copy to District files; if protested application, copy to HQ Hearing & Legal and Division
Office.
ABC-209 (rev. 07-19)
Department of Alcoholic Beverage Control
State of California
Gavin Newsom, Governor
APPLICATION WITHDRAWAL
Read instructions on reverse before completing.
DATE OF WITHDRAWAL
PENDING FILE NUMBER
1. APPLICANT(S) NAME(S)
2. COPIES MAILED DATE
3. APPLICANT PREMISES ADDRESS (proposed premises)
4. LICENSE TYPE(S) APPLIED FOR
5. TRANSACTION TYPE
Original
Person to Person Transfer
Double Transfer
Exchange
Premises Transfer
Other
6. TRANSFEROR NAME (if applicable)
7. TRANSFEROR PREMISES ADDRESS (if applicable)
8. REASON FOR WITHDRAWAL
9. REFUND INFORMATION
The undersigned hereby request the Department of Alcoholic Beverage Control to withdraw the above-described
application and to refund or apply the fee as follows if a refund is applicable per Section 23320 B&P.
Make refund payable to the applicant entity(s) as listed on Form ABC-211, Application for ABC License.
Make refund payable to:
I agree to submit documentation to ABC Headquarters within 15 days from the date I sign this withdrawal that the foregoing
person paid the license fees. I understand that failure to submit documentation will result in the refund being made payable to
the entity(s) shown on Form ABC-211, Application for ABC License.
Apply any refundable portion on supplemental application for:
10. MAILING ADDRESS FOR REFUND (Street number and name, city, state, zip code)
11. APPLICANT SIGNATURE
PRINTED NAME
DATE SIGNED
X
12. TRANSFEROR SIGNATURE (If applicable)
PRINTED NAME
DATE SIGNED
X
13. SIGNATURE OF WITNESS
PRINTED NAME
DATE SIGNED
X
ABC USE ONLY
If protested application, District Administrator/District Supervisor must complete this section. Investigation reveals:
Application withdrawn due to protest. Applicant may not refile at this premises for one year (Section 24013.1 B&P Code).
Application withdrawn due to protest against premises. Protests to remain valid at this premises for one
year (Section 24013.2 B&P Code).
Application not withdrawn due to the valid protest(s). Protests not to be carried forward.
DISTRICT ADMINISTRATOR/DISTRICT SUPERVISOR SIGNATURE
DATE SIGNED
Original to HQ Licensing; copy to District files; if protested application, copy to HQ Hearing & Legal and Division
Office.
ABC-209 (rev. 07-19)

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