"Application for a Permit to Import Sacramental Wine Into the State of Oregon" - Oregon

Application for a Permit to Import Sacramental Wine Into the State of Oregon is a legal document that was released by the Oregon Liquor and Cannabis Commission - a government authority operating within Oregon.

Form Details:

  • Released on December 9, 2018;
  • The latest edition currently provided by the Oregon Liquor and Cannabis Commission;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Oregon Liquor and Cannabis Commission.

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Application for a Permit to Import
Sacramental Wine into the State
of Oregon
A religious organization in Oregon wanting to import wine into Oregon for sacramental use only and not
for resale must obtain a permit from the OLCC.
A religious organization wanting to use wine already legally in Oregon for sacramental use only and not
for resale does not need a permit from the OLCC.
To obtain a permit from the OLCC to import sacramental wine into Oregon, an authorized representative
of the religious organization should complete this application and send it to the OLCC.
Name of Religious Organization: _______________________________________________________
Address: ___________________________________________________________________________
(Number and Street)
______________________________________________________________
___________________
(City)
(Zip Code)
Name of Contact Person: ______________________________________________________________
Phone Number: ___________________________
Email: ___________________________________
Is the religious organization listed above a religious organization exempt from filing federal taxes
under IRC Section 501(c)(3)?
□ Yes. If yes, please attach a copy of your 501(c)(3) statement to this application.
□ No. If no, the OLCC will not be able to approve this application.
By signing this application, I attest that I am an authorized representative of the religious
organization listed above, accept full responsibility for the importation of the wine, and certify that
the wine is for sacramental use only and will not be sold.
Printed Name of Person Signing: _______________________________________________________
Signature: ________________________________________________ Date: ____________________
This permit is valid only when signed by an OLCC representative. Once this application is signed by
OLCC, it is proof of authority to import wine for sacramental purposes.
Return to: OLCC, ATTN: Jamie Dickinson, PO Box 22297, Milwaukie, Or, 97269
Email:
Jamie.Dickinson@oregon.gov
Phone: 503-872-6396
OLCC USE ONLY
Permit is approved on ________________________________
By: ____________________________
(Date)
(OLCC representative)
Approval sent to applicant on ______________________________________
(Date)
Rev: 9.12.18
Application for a Permit to Import
Sacramental Wine into the State
of Oregon
A religious organization in Oregon wanting to import wine into Oregon for sacramental use only and not
for resale must obtain a permit from the OLCC.
A religious organization wanting to use wine already legally in Oregon for sacramental use only and not
for resale does not need a permit from the OLCC.
To obtain a permit from the OLCC to import sacramental wine into Oregon, an authorized representative
of the religious organization should complete this application and send it to the OLCC.
Name of Religious Organization: _______________________________________________________
Address: ___________________________________________________________________________
(Number and Street)
______________________________________________________________
___________________
(City)
(Zip Code)
Name of Contact Person: ______________________________________________________________
Phone Number: ___________________________
Email: ___________________________________
Is the religious organization listed above a religious organization exempt from filing federal taxes
under IRC Section 501(c)(3)?
□ Yes. If yes, please attach a copy of your 501(c)(3) statement to this application.
□ No. If no, the OLCC will not be able to approve this application.
By signing this application, I attest that I am an authorized representative of the religious
organization listed above, accept full responsibility for the importation of the wine, and certify that
the wine is for sacramental use only and will not be sold.
Printed Name of Person Signing: _______________________________________________________
Signature: ________________________________________________ Date: ____________________
This permit is valid only when signed by an OLCC representative. Once this application is signed by
OLCC, it is proof of authority to import wine for sacramental purposes.
Return to: OLCC, ATTN: Jamie Dickinson, PO Box 22297, Milwaukie, Or, 97269
Email:
Jamie.Dickinson@oregon.gov
Phone: 503-872-6396
OLCC USE ONLY
Permit is approved on ________________________________
By: ____________________________
(Date)
(OLCC representative)
Approval sent to applicant on ______________________________________
(Date)
Rev: 9.12.18