Form ABC-811 "P-12 Request/Acknowledgement Form" - California

What Is Form ABC-811?

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 November 1, 2011;
  • 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-811 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-811 "P-12 Request/Acknowledgement Form" - California

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P-12 Request/Acknowledgement Form
The following is to be completed by an applicant who currently holds one or more permanent
license(s) issued by the Department and has been granted, or is requesting, P-12 status:
LICENSEE/APPLICANT:
CHECK ONE:
Our designated base/master file is held in the Department’s ________________ District
Office under file number __________.
We are requesting P-12 status under file number ____________ held in the Department’s
__________________ District Office.
We hereby request waiver of submission of documents which would otherwise be required to
establish our qualification as an applicant for an alcoholic beverage license.
We hereby attest, under penalty of perjury, that all information (including forms
ABC-208 [Personal Affidavit], ABC-243 [Corporate Questionnaire], ABC-256 [Limited
Partnership Questionnaire], ABC-256-LLC [Limited Liability Questionnaire] and all related
supporting documents) in the above-identified licensing file are accurate and current.
We understand that we are required to report any changes to our licensed entity, pursuant to
Business and Professions Code Sections 24071, 24071.1, and/or 24071.2, and California Code of
Regulations Rule 68.5.
We recognize that a determination by the Department that this statement is materially false could
lead to denial of this application and/or disciplinary action against license(s) held by the
applicant.
_______________________________________
________________
Signature of Applicant
Date
ABC-811 (11/11)
P-12 Request/Acknowledgement Form
The following is to be completed by an applicant who currently holds one or more permanent
license(s) issued by the Department and has been granted, or is requesting, P-12 status:
LICENSEE/APPLICANT:
CHECK ONE:
Our designated base/master file is held in the Department’s ________________ District
Office under file number __________.
We are requesting P-12 status under file number ____________ held in the Department’s
__________________ District Office.
We hereby request waiver of submission of documents which would otherwise be required to
establish our qualification as an applicant for an alcoholic beverage license.
We hereby attest, under penalty of perjury, that all information (including forms
ABC-208 [Personal Affidavit], ABC-243 [Corporate Questionnaire], ABC-256 [Limited
Partnership Questionnaire], ABC-256-LLC [Limited Liability Questionnaire] and all related
supporting documents) in the above-identified licensing file are accurate and current.
We understand that we are required to report any changes to our licensed entity, pursuant to
Business and Professions Code Sections 24071, 24071.1, and/or 24071.2, and California Code of
Regulations Rule 68.5.
We recognize that a determination by the Department that this statement is materially false could
lead to denial of this application and/or disciplinary action against license(s) held by the
applicant.
_______________________________________
________________
Signature of Applicant
Date
ABC-811 (11/11)