Form ABC-239 "Additional License/Permit Application" - California

What Is Form ABC-239?

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 September 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-239 by clicking the link below or browse more documents and templates provided by the California Department of Alcoholic Beverage Control.

ADVERTISEMENT
ADVERTISEMENT

Download Form ABC-239 "Additional License/Permit Application" - California

478 times
Rate (4.8 / 5) 24 votes
Department of Alcoholic Beverage Control
State of California
ADDITIONAL LICENSE/PERMIT APPLICATION
(ABC Use Only)
LICENSE NUMBER
Effective July 1, 2012 Revenue and Taxation Code, Section 7057,
authorizes the State Board of Equalization and the Franchise Tax
RECEIPT NUMBER
Board to share taxpayer information with the Department of
Alcoholic Beverage Control. The Department may suspend, revoke,
FEE PAID
COPIES MAILED DATE
and refuse to issue a license if the licensee's name appears in the
500 largest tax deliquencies list. (Business and Professions Code
$
Section 494.5.)
DISTRICT CODE
GEO CODE
SECTION 1- LICENSEE(S) INFORMATION
1. LICENSEE'S NAME
2. DOING BUSINESS AS (DBA)
3.DATE
4. PROPOSED PREMISES ADDRESS
5. DISTRICT OFFICE
6. MAILING ADDRESS
7. LICENSEE'S PHONE NUMBER
SECTION 2- APPLICATION FOR PERMIT/LICENSE
8. TYPE OF PERMIT/LICENSE
9. NUMBER OF PERMIT/LICENSES
10. PRINCIPAL/MASTER LICENSE NUMBER
I/We apply for the permit/license(s) checked below
a. Caterer's Permit (Type 58)
f. Brandy Importer (Typer 11)
j. Duplicate (Type 48)
b. Controlled Access Cabinet (Type 66)
g. Distilled Spirits Importer (Type 12)
k. Event Permit (Type 77)
c. Portable Bar (Type 68)
h. Duplicate (Type 02)
l. Certified Farmer's Market (Type 79 or 84)
d. Beer & Wine Importer (Type 09)
i. Duplicate (Type 47)
m. Other
e. Duplicate (Type 01 or 23)
----
Retail Sales/Tasting location?
*Yes
No
*Beer Manufacturing Temporary Permit requested - please check
SECTION 3- SIGNATURE (Only one signature required)
11. CERTIFICATION FOR SIGNATURE OF A LICENSED PRINCIPAL
I declare under penalty of perjury that I am authorized to sign for licensed entity identified in Item 1, above.
I have read the foregoing and know the contents thereof. Signature must be notorized unless witnessed by ABC employee.
12. SIGNATURE
13. PRINTED NAME AND TITLE
14. DATE
ABC USE ONLY
RECOMMENDATION
AGENT'S SIGNATURE (if investigation required)
DATE SIGNED
RECOMMENDATION
SUPERVISOR'S SIGNATURE
DATE SIGNED
Distribution: Original to Headquarters Cashier
ABC-220 to follow
ABC-239 (rev. 9/14)
Conditions to follow; Hold in HQ until received
Department of Alcoholic Beverage Control
State of California
ADDITIONAL LICENSE/PERMIT APPLICATION
(ABC Use Only)
LICENSE NUMBER
Effective July 1, 2012 Revenue and Taxation Code, Section 7057,
authorizes the State Board of Equalization and the Franchise Tax
RECEIPT NUMBER
Board to share taxpayer information with the Department of
Alcoholic Beverage Control. The Department may suspend, revoke,
FEE PAID
COPIES MAILED DATE
and refuse to issue a license if the licensee's name appears in the
500 largest tax deliquencies list. (Business and Professions Code
$
Section 494.5.)
DISTRICT CODE
GEO CODE
SECTION 1- LICENSEE(S) INFORMATION
1. LICENSEE'S NAME
2. DOING BUSINESS AS (DBA)
3.DATE
4. PROPOSED PREMISES ADDRESS
5. DISTRICT OFFICE
6. MAILING ADDRESS
7. LICENSEE'S PHONE NUMBER
SECTION 2- APPLICATION FOR PERMIT/LICENSE
8. TYPE OF PERMIT/LICENSE
9. NUMBER OF PERMIT/LICENSES
10. PRINCIPAL/MASTER LICENSE NUMBER
I/We apply for the permit/license(s) checked below
a. Caterer's Permit (Type 58)
f. Brandy Importer (Typer 11)
j. Duplicate (Type 48)
b. Controlled Access Cabinet (Type 66)
g. Distilled Spirits Importer (Type 12)
k. Event Permit (Type 77)
c. Portable Bar (Type 68)
h. Duplicate (Type 02)
l. Certified Farmer's Market (Type 79 or 84)
d. Beer & Wine Importer (Type 09)
i. Duplicate (Type 47)
m. Other
e. Duplicate (Type 01 or 23)
----
Retail Sales/Tasting location?
*Yes
No
*Beer Manufacturing Temporary Permit requested - please check
SECTION 3- SIGNATURE (Only one signature required)
11. CERTIFICATION FOR SIGNATURE OF A LICENSED PRINCIPAL
I declare under penalty of perjury that I am authorized to sign for licensed entity identified in Item 1, above.
I have read the foregoing and know the contents thereof. Signature must be notorized unless witnessed by ABC employee.
12. SIGNATURE
13. PRINTED NAME AND TITLE
14. DATE
ABC USE ONLY
RECOMMENDATION
AGENT'S SIGNATURE (if investigation required)
DATE SIGNED
RECOMMENDATION
SUPERVISOR'S SIGNATURE
DATE SIGNED
Distribution: Original to Headquarters Cashier
ABC-220 to follow
ABC-239 (rev. 9/14)
Conditions to follow; Hold in HQ until received