Form ABC-251 "Statement Re: Consideration Points" - California

What Is Form ABC-251?

This is a legal form that was released by the California Department of Alcoholic Beverage Control - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2014;
  • 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-251 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-251 "Statement Re: Consideration Points" - California

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Department of Alcoholic Beverage Control
State of California
Edmund G. Brown Jr., Governor
STATEMENT RE: CONSIDERATION POINTS
Applicant:
Please complete left side of form, then sign. List the names and addresses of all schools, churches, hospitals, public
playgrounds, and youth facilities located within 600 feet of your proposed premises. Measure all distances by direct line from the
closest edge of the facility structure to the closest edge of your structure. Continue on reverse if needed.
1. APPLICANT NAME
2. PREMISES ADDRESS (Street number and name, city, zip code)
3. FACILITY NAME/ADDRESS
DEPARTMENT USE ONLY
LTR
PERS
DATE
DISTANCE
SEPARATION FACTORS
1.
FT.
NAME
LTR
PERS
DATE
2.
FT.
NAME
LTR
PERS
DATE
3.
FT.
NAME
LTR
PERS
DATE
4.
FT.
NAME
LTR
PERS
DATE
5.
FT.
NAME
LTR
PERS
DATE
6.
FT.
NAME
LTR
PERS
DATE
7.
FT.
NAME
LTR
PERS
DATE
8.
FT.
NAME
LTR
PERS
DATE
9.
FT.
NAME
I acknowledge that any false, misleading or omitted information required in this statement may constitute grounds for denial of the application
for the license, or, if the license is issued in reliance upon information in this statement which is omitted, false or misleading, then such
misinformation or omission will constitute grounds for revocation of the license so issued.
4. APPLICANT SIGNATURE
DATE SIGNED
ABC-251 (rev. 05-14)
Department of Alcoholic Beverage Control
State of California
Edmund G. Brown Jr., Governor
STATEMENT RE: CONSIDERATION POINTS
Applicant:
Please complete left side of form, then sign. List the names and addresses of all schools, churches, hospitals, public
playgrounds, and youth facilities located within 600 feet of your proposed premises. Measure all distances by direct line from the
closest edge of the facility structure to the closest edge of your structure. Continue on reverse if needed.
1. APPLICANT NAME
2. PREMISES ADDRESS (Street number and name, city, zip code)
3. FACILITY NAME/ADDRESS
DEPARTMENT USE ONLY
LTR
PERS
DATE
DISTANCE
SEPARATION FACTORS
1.
FT.
NAME
LTR
PERS
DATE
2.
FT.
NAME
LTR
PERS
DATE
3.
FT.
NAME
LTR
PERS
DATE
4.
FT.
NAME
LTR
PERS
DATE
5.
FT.
NAME
LTR
PERS
DATE
6.
FT.
NAME
LTR
PERS
DATE
7.
FT.
NAME
LTR
PERS
DATE
8.
FT.
NAME
LTR
PERS
DATE
9.
FT.
NAME
I acknowledge that any false, misleading or omitted information required in this statement may constitute grounds for denial of the application
for the license, or, if the license is issued in reliance upon information in this statement which is omitted, false or misleading, then such
misinformation or omission will constitute grounds for revocation of the license so issued.
4. APPLICANT SIGNATURE
DATE SIGNED
ABC-251 (rev. 05-14)