Form EH10.02-09 "Incorporated City Priority List Liquor License Application" - Idaho

What Is Form EH10.02-09?

This is a legal form that was released by the Idaho State Police - a government authority operating within Idaho. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2013;
  • The latest edition provided by the Idaho State Police;
  • 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 printable version of Form EH10.02-09 by clicking the link below or browse more documents and templates provided by the Idaho State Police.

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Download Form EH10.02-09 "Incorporated City Priority List Liquor License Application" - Idaho

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Idaho State Police
Alcohol Beverage Control
700 S. Stratford Dr. Ste 115
Meridian, ID 83642
(208) 884-7060
Incorporated City Priority List Liquor License Application
. City and County for the proposed license: _____________________________________
1
2. License Type and Fees
Application Fee Enclosed $ ____________
Business must be located within the incorporated city limits
of the city being applied
for.
3.
Applicant Information
: ______________________________________________________________
Applicant Name
(Applicant Name: Individual(s), Corporation, LLC or Partnership)
Mailing Address: _______________________________________________________________________
City, State, Zip: _______________________________________________________________________
Daytime Telephone: _____________________ Nighttime Telephone: ____________________________
Federal or State Tax I.D. Number for Corp., LLC or Partnership: _______________________________
SSN for Individual(s)/Sole Proprietor(s): ___________________________________
4.
List sole proprietor(s) or all partners, corporate officers, directors, ten primary stockholders,
LLC/LLP members/partners of the applicant.
Attach a separate sheet of paper following the format below.
Name: ______________________________________ Address: __________________________________________
Title: _____________________ SSN: ______________________________ DoB: ____________________________
Idaho Resident: (Y/N) _________________________ If ‘YES’ length of residency: __________________________
5. Read the following, Sign and have notarized.
The applicant hereby swears or affirms under oath that the applicant is the bona fide owner of the business which will be engaged in
the sale or dispensing of liquor by the drink, beer and/or wine by the bottle and/or glass upon issuance of the license. The applicant
hereby affirms that the applicant is eligible and has none of the disqualifications for a license as provided by Title 23, Chapter 9, 10,
11, 13 and 14, Idaho Code or any amendments thereto. Applicant further acknowledges that they and/or each person indicated on
this application or attachments understand that state law controlling alcohol beverage licensing is found at Title 23, Idaho Code and
the Alcohol Beverage Control administrative rules found at IDAPA .05.01, and that any violation of these laws or rules can result in
criminal and/or administrative sanctions, and up to and including license revocation.
I/we, the applicant of this license, have read all of the above and declare under penalty of perjury that the information that I/we
have provided is true and correct to the best of my/our knowledge.
____________________________________ ____________________ _______________
Authorized Agent or Applicant’s Signature
Title
Date
______________________________________________________
Authorized Agent/Applicant’s Printed Name
Subscribed and sworn to before me this ______ day of ______________, 20____.
__________________________________________
Notary Public
Residing At_____________________________________
(Seal)
: _________________________
My Commission Expires
EH 10.02-09
Rev 03/2013
Idaho State Police
Alcohol Beverage Control
700 S. Stratford Dr. Ste 115
Meridian, ID 83642
(208) 884-7060
Incorporated City Priority List Liquor License Application
. City and County for the proposed license: _____________________________________
1
2. License Type and Fees
Application Fee Enclosed $ ____________
Business must be located within the incorporated city limits
of the city being applied
for.
3.
Applicant Information
: ______________________________________________________________
Applicant Name
(Applicant Name: Individual(s), Corporation, LLC or Partnership)
Mailing Address: _______________________________________________________________________
City, State, Zip: _______________________________________________________________________
Daytime Telephone: _____________________ Nighttime Telephone: ____________________________
Federal or State Tax I.D. Number for Corp., LLC or Partnership: _______________________________
SSN for Individual(s)/Sole Proprietor(s): ___________________________________
4.
List sole proprietor(s) or all partners, corporate officers, directors, ten primary stockholders,
LLC/LLP members/partners of the applicant.
Attach a separate sheet of paper following the format below.
Name: ______________________________________ Address: __________________________________________
Title: _____________________ SSN: ______________________________ DoB: ____________________________
Idaho Resident: (Y/N) _________________________ If ‘YES’ length of residency: __________________________
5. Read the following, Sign and have notarized.
The applicant hereby swears or affirms under oath that the applicant is the bona fide owner of the business which will be engaged in
the sale or dispensing of liquor by the drink, beer and/or wine by the bottle and/or glass upon issuance of the license. The applicant
hereby affirms that the applicant is eligible and has none of the disqualifications for a license as provided by Title 23, Chapter 9, 10,
11, 13 and 14, Idaho Code or any amendments thereto. Applicant further acknowledges that they and/or each person indicated on
this application or attachments understand that state law controlling alcohol beverage licensing is found at Title 23, Idaho Code and
the Alcohol Beverage Control administrative rules found at IDAPA .05.01, and that any violation of these laws or rules can result in
criminal and/or administrative sanctions, and up to and including license revocation.
I/we, the applicant of this license, have read all of the above and declare under penalty of perjury that the information that I/we
have provided is true and correct to the best of my/our knowledge.
____________________________________ ____________________ _______________
Authorized Agent or Applicant’s Signature
Title
Date
______________________________________________________
Authorized Agent/Applicant’s Printed Name
Subscribed and sworn to before me this ______ day of ______________, 20____.
__________________________________________
Notary Public
Residing At_____________________________________
(Seal)
: _________________________
My Commission Expires
EH 10.02-09
Rev 03/2013
ALCOHOL BEVERAGE CONTROL
700 S. Stratford Dr. Ste 115 Meridian, ID 83642
(208) 884-7060, ABC@isp.idaho.gov
INSTRUCTIONS FOR PRIORITY LIQUOR WAITING LIST
Forms must be legible (Print or Type)
All blanks must be completed. Follow all instructions printed on each form. An incomplete application will be
returned.
All forms must be signed and notarized.
Fees must accompany the application. Do not mail cash.
Completing the application: Instructions follow the order of the application.
1. City and County for the proposed license: Write the city and county that you would like to be issued a license for.
2. License Type and Fees: The fee for the future liquor waiting list is 1/2 the annual renewal fee for the liquor
license in the city for which you are applying for. Ex. Boise City - $375 ($750 annual). McCall - $250 ($500
annual).
3. Applicant Information: Write in all of the required information as listed. N/A is not acceptable.
a. Applicant means: Individual(s), partnership, corporation, LLC, or association that will be conducting the
business
4. List of Applicants/Agents: List all persons associated with the applicant. Follow the format listed and attach a
separate sheet of paper if necessary.
5. Read, sign and have notarized.
Upon receipt of your completed application, your name will be entered at the bottom of the waiting list for the city you
chose.
Licenses are issued by increase in the population. ABC receives estimated population statistics from the Dept. of
Commerce/US Census Bureau each year and actual population statistics every 10 years. Licenses are offered to
applicants starting at the top of the list.
In order to assist ABC in notifying you when you are at the top of the list, you must notify our office in writing if
you have a change of address. If we cannot locate you to offer you a license, your name will be removed and
deposit refunded.
A list is not maintained for cities that are not incorporated or that do not allow the sale of liquor.
For more information see IDAPA Rules 11.05.01.013.
Rev. 10/2010
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