Form TA Temporary Operating Authority/Temporary Gambling Authority - Montana

Form TA or the "Temporary Operating Authority/temporary Gambling Authority" is a form issued by the Montana Department of Revenue.

Download a PDF version of the Form TA down below or find it on the Montana Department of Revenue Forms website.

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CLEAR FORM
Temporary Operating Authority/Temporary Gambling Authority
Applications with Temporary Operating Authority or Temporary Gambling Authority requested may
only be submitted electronically through TransAction Portal (TAP) at https://tap.dor.mt.gov/_/.
The Montana Department of Revenue Liquor Control Division may grant temporary operating authority and
the Montana Department of Justice Gambling Control Division may grant temporary gambling authority to an
applicant who requests a transfer of ownership, transfer of location or a new license. This authority may only
be granted if the premises were licensed within the last 12 months, the premises were not altered from the last
floor plan and the application meets the requirements listed in
ARM 42.12.208
for alcoholic beverages and
ARM 23.16.509
for gambling.
Temporary operating authority is requested for alcoholic beverages.
 Yes
 No
Temporary gambling authority is requested for gambling.
 Yes
 No
(Transfer Only) Alcoholic Beverages License Number
-
-
-
To Be Completed By Applicant
The undersigned applicant requests authority to operate pending final approval of the application. This
authority will be immediately revoked if the applicant or any employees violate any provision of the Montana
Alcoholic Beverage Code or the department’s rules. If it is revoked as described in
ARM 42.12.208(5)
or
ARM
23.16.509(4), all alcoholic beverages and gambling activities on applicant’s premises must immediately cease.
_______________________________________________________________
Name of Applicant Entity
_______________________________________________________________
_______________________
Signature of Applicant/Authorized Representative
Date
________________________________________________________________________________________
Printed Name and Position
The above authority is requested to begin _____________________________
Date
To Be Completed By Current Licensee (Transfers Only)
I authorize the above authority to be granted to the applicant pending final approval of the transfer application.
I understand the applicant may not operate the business until approval of the authority has been granted. I
understand ARM 42.12.208 states in part “Any proposed fine, suspension or revocation arising out of a
violation will be assessed against, and is the responsibility of, the recorded owner of the license.”
_______________________________________________________________
_______________________
Signature of Current Licensee
Date
_______________________________________________________________
Printed Name
Form TA - Rev 01 17
CLEAR FORM
Temporary Operating Authority/Temporary Gambling Authority
Applications with Temporary Operating Authority or Temporary Gambling Authority requested may
only be submitted electronically through TransAction Portal (TAP) at https://tap.dor.mt.gov/_/.
The Montana Department of Revenue Liquor Control Division may grant temporary operating authority and
the Montana Department of Justice Gambling Control Division may grant temporary gambling authority to an
applicant who requests a transfer of ownership, transfer of location or a new license. This authority may only
be granted if the premises were licensed within the last 12 months, the premises were not altered from the last
floor plan and the application meets the requirements listed in
ARM 42.12.208
for alcoholic beverages and
ARM 23.16.509
for gambling.
Temporary operating authority is requested for alcoholic beverages.
 Yes
 No
Temporary gambling authority is requested for gambling.
 Yes
 No
(Transfer Only) Alcoholic Beverages License Number
-
-
-
To Be Completed By Applicant
The undersigned applicant requests authority to operate pending final approval of the application. This
authority will be immediately revoked if the applicant or any employees violate any provision of the Montana
Alcoholic Beverage Code or the department’s rules. If it is revoked as described in
ARM 42.12.208(5)
or
ARM
23.16.509(4), all alcoholic beverages and gambling activities on applicant’s premises must immediately cease.
_______________________________________________________________
Name of Applicant Entity
_______________________________________________________________
_______________________
Signature of Applicant/Authorized Representative
Date
________________________________________________________________________________________
Printed Name and Position
The above authority is requested to begin _____________________________
Date
To Be Completed By Current Licensee (Transfers Only)
I authorize the above authority to be granted to the applicant pending final approval of the transfer application.
I understand the applicant may not operate the business until approval of the authority has been granted. I
understand ARM 42.12.208 states in part “Any proposed fine, suspension or revocation arising out of a
violation will be assessed against, and is the responsibility of, the recorded owner of the license.”
_______________________________________________________________
_______________________
Signature of Current Licensee
Date
_______________________________________________________________
Printed Name
Form TA - Rev 01 17

Download Form TA Temporary Operating Authority/Temporary Gambling Authority - Montana

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