FORM L-102A (9/2011) INFORMATION AND INSTRUCTION FOR AIRLINE BEVERAGE, CARRIER’S, INDUSTRIAL, LOCAL INDUSTRIAL ALCOHOL MANUFACTURER’S, MARKET RESEARCH PACKAGER’S, AND PASSENGER TRAIN BEVERAGE PERMITS AIRLINE BEVERAGE PERMIT- Allows the holder to sell or serve alcoholic beverages in or from any size container on a commercial passenger airplane operated in compliance with a valid license, permit or certificate issued under the authority of the United States or of this state, even though the plane, in the course of its flight, may cross an area in which the sale of alcoholic beverages in prohibited. Also, allows the holder to store alcoholic beverages in sealed containers of any size at any airport regularly served by the permittee, in accordance with rules and regulations promulgated by the Commission. The State fee is $4,400 with a surcharge of $327 and the permit will expire two years from date of issuance. This permit may only be issued to a corporation operating a commercial airline in or through the State. CARRIER’S PERMIT- Allows the holder to transport liquor into and out of this state and between points within the state. Also, may transport liquor from one wet area to another wet area across a dry area if that course of transportation is necessary or convenient. A carrier’s permit may be issued to a water carrier; an airline; a railway; a motor carrier registered under Chapter 643, Transportation Code, or by a common motor carrier operating under a certificate issued by the Interstate Commerce Commission. Each carrier must hold a carrier’s permit issued under Chapter 41 of the code. All provisions of Chapter 41 relating to the transportation of liquor also apply to the transportation of beer. A carrier may not transport beer into the state unless it is consigned to an importer. The State fee is $60 with a surcharge of $252 and the permit will expire two years from date of issuance. INDUSTRIAL PERMIT- Allows the holder to import, transport, and use alcohol or denatured alcohol for the manufacture and sale of: denatured alcohol; patent, proprietary, medicinal, pharmaceutical, antiseptic, and toilet preparations; flavoring extracts, syrups, condiments and food products; scientific, chemical, mechanical and industrial products or products used for scientific, chemical mechanical, industrial or medicinal purposes. The State fee is $120 with a surcharge of $261 and will expire two years from date of issuance. LOCAL INDUSTRIAL ALCOHOL MANUFACTURER’S PERMIT- Allows the holder to manufacture, rectify, and refine industrial alcohol (not fit for human consumption); denature alcohol produces under this permit; sell denatured or industrial alcohol produced under the permit to holders of local industrial alcohol manufacturer’s permits or industrial permits and to qualified persons outside the state; blend industrial alcohol produced under the permit with petroleum distillates and sell or use the resulting product as motor fuel. The State fee is $200 with a surcharge of $327 and will expire two years from date of issuance. MARKET RESEARCH PACKAGER’S PERMIT- Allows the holder to receive from a winery, distiller’s or brewer’s permittee or manufacturer’s licensee in this state, alcoholic beverages produced by and belonging to the permittee or licensee; receive alcoholic beverages produced by and belonging to an authorized person outside this state; place the alcoholic beverages in containers or packaging material as a service to the producer of the beverages in connection with a market research program; return the alcoholic beverages to the licensee, permittee or authorized person from whom they were received. The State fee is $200 with a surcharge of $127 and will expire two years from date of issuance. PASSENGER TRAIN BEVERAGE PERMIT- Allows a corporation organized under Title 112, Revised, Statuses, or under the Rail Passenger Service Act of 1970 as amended (45 U.S.C.A. Section 501 et seq.) operating passenger train service in or through the state to sell or serve alcoholic beverages in or from any size container on a commercial passenger train. Also, allows the holder to store alcoholic beverages in sealed containers of any size at any depot regularly served by the permittee, in accordance with rules and regulations promulgated by the Commission. The State fee is $1,000 with a surcharge of $602 and will expire two years from date of issuance. (CONTINUED ON NEXT PAGE) P.O. Box 13127, Austin, Texas 78711-3127 (512) 206-3333 An Equal Opportunity Employer www.tabc.state.tx.us FORM L-102A (9/2011) Page 2 of 2 INSTRUCTIONS 1. Beginning January 1, 2009, the permits covered under this form will be issued for a two-year period. You MUST renew for the entire two-year period. 2. If applying for an Airline Beverage, Carrier’s, Industrial, Market Research Packager’s or Passenger Train Beverage permits, prepare the application in duplicate. All applicants should answer numbers 1-6. Number 7 pertains only to individual applicants. Answer all questions applicable to permit type. Partnerships and corporations must answer numbers 1 and 2 on Form L-102-PC. Ensure application is signed by individual/officer/manager/partner and a notary public has acknowledged the signature. Mail original application with proper fees and surcharges to the Texas Alcoholic Beverage Commission, P.O. Box 13127, Austin, Texas 78711. Keep duplicate for your records. 3. If applying for a Local Industrial Alcohol Manufacturer’s Permit, prepare the application in triplicate. Mail the original and one copy to the commission’s office in the area where the business is located. Ensure proper fees and surcharges are filed with application. All applicants should answer numbers 1 through 6. Number 7 pertains only to individual applicants. Partnerships and corporations must answer numbers 1 and 2 on Form L-102-PC. Answer all questions applicable to permit type. Ensure application is signed by individual/officer/manager/partner and have signature acknowledged by a notary public. To avoid a delay in processing your application, immediately contact the TABC district office in your area for the correct procedure. Your application will be delayed if not processed through our district office. 4. If street address is not known, give the name of street or highway where the business is located, indicate which side (north, south, east, or west) of the street, and describe to some fixed point. Example: Hwy. 10 West Side, 1 mile North Courthouse or Hwy. 10 West Side, 1 mile North Intersection Hwy. 20. If not located in a city or town, give name or number of the road or highway, which side and the distance and direction from some fixed point, such as the courthouse or post office of nearest city or town in the county where the application is filed. 5. Consult chart below for fees and surcharges. The total amount of fees plus surcharges to cover the two-year period MUST be paid at the time of renewal. Fees may NOT be prorated or refunded. Submit your application along with permit fees and surcharges with a cashier’s check, money order, or firm check from corporate permittee payable to the Comptroller of Public Accounts. Fees *Surcharge Effective 9/1/2011 Total Due $4,400 $327 $4,727 Carrier’s Permit $60 $252 $312 Industrial Permit $120 $261 $381 Local Industrial Alcohol Manufacturer’s Permit $200 $327 $527 Market Research Packager’s Permit $200 $127 $327 $1,000 $602 $1,602 Type of Permit Airline Beverage Permit Passenger Train Beverage Permit 5. *SURCHARGES ARE SUBJECT TO ANNUAL CHANGE. The surcharges assessed each year are determined by the Texas Alcoholic Beverage Commission and not by the Legislature. The Legislature determines the total dollar amount to be raised in agency revenue. The revenue is comprised of fees set by the Legislature, and surcharges are determined by the agency. 6. If you need more information, call (512) 206-3360 for assistance. Sincerely, Amy Harrison, Director APPLICATION FOR AIRLINE BEVERAGE PERMIT, CARRIER’S PERMIT, INDUSTRIAL PERMIT, LOCAL INDUSTRIAL ALCOHOL MANUFACTURER’S PERMIT, MARKET RESEARCH PACKAGER’S PERMIT, PASSENGER TRAIN BEVERAGE PERMIT TABC USE ONLY TYPE OR PRINT IN INK FORM L-102 (2/2009) ISSUE DATE FEE SURCHARGE LATE FEE (RENEWAL ONLY) 1A. APPLICATION FILED FOR: Registry No. AB AIRLINE BEVERAGE PERMIT (ONLY FOR CORPORATIONS) C CARRIER’S PERMIT I INDUSTRIAL PERMIT LI LOCAL INDUSTRIAL ALCOHOLIC MANUFACTURER’S PERMIT MR MARKET RESEARCH PACKAGER’S PERMIT PT PASSENGER TRAIN BEVERAGE PERMIT (ONLY FOR CORPORATIONS) AB, C, I, LI, MR, PT B. APPLICATION FILED FOR: Original Renewal Change Change: C. If renewal or change, enter license/permit no(s).: 2. APPLICATION IS FILED BY: Individual Partnership Corporation Limited Partnership Limited Liability Company Limited Liability Partnership Other: 3. Trade Name of Business 4. Address or Location City County 5. Mailing Address 6. Area Code + Business Telephone Number City/Foreign Country Area Code + Alternate Telephone Number State Zip Code (9 digits) State Zip Code (9 digits) E-mail Address (optional) TABC USE ONLY FOR INDIVIDUAL FOR INDIVIDUAL Issuing State and Driver’s License Number 7. Social Security Number Date of Birth (mm/dd/yyyy) Full Legal Name (Last, First, Middle) Residential Address City PROCESSOR REVIEW DATE / / WRITTEN PROCESS DATE END PROCESS DATE / / PROCESSOR I.D. State Zip Code (9 digits) / / Page 1 of 4 P A R T N E R S H I P S /C O R P O R A T I O N S TRADE NAME: FORM L-102-PC (12/2007) 1A. Indicate type of ownership and complete the information below: Corporation Limited Liability Company Partnership Limited Partnership Limited Liability Partnership B. Federal Employer’s I.D. No.: C. Entity Name: D. Charter No.: 2. State: COMPLETE THE FOLLOWING PER INSTRUCTIONS: Social Security Number FOR ALL OFFICER(S), PARTNER(S), DIRECTOR(S) AND MANAGER(S) Date Approved: Issuing State/ Driver’s License Number Full Legal Name of Partner (Last, First, Middle) Officer Partner Residential Address Social Security Number City Issuing State/ Driver’s License Number Full Legal Name of Partner (Last, First, Middle) Officer Partner Residential Address Social Security Number Issuing State/ Driver’s License Number Officer Partner Residential Address Issuing State/ Driver’s License Number Officer Partner Residential Address Issuing State/ Driver’s License Number Officer Partner Residential Address Director/Manager City Issuing State/ Driver’s License Number Full Legal Name of Partner (Last, First, Middle) Residential Address Director/Manager City Full Legal Name of Partner (Last, First, Middle) Social Security Number Director/Manager City Full Legal Name of Partner (Last, First, Middle) Social Security Number Director/Manager City Full Legal Name of Partner (Last, First, Middle) Social Security Number Director/Manager Officer Partner Director/Manager City Date of Birth (mm/dd/yyyy) Title State ZIP Code (9 Digits) Date of Birth (mm/dd/yyyy) Title State ZIP Code (9 Digits) Date of Birth (mm/dd/yyyy) Title State ZIP Code (9 Digits) Date of Birth (mm/dd/yyyy) Title State ZIP Code (9 Digits) Date of Birth (mm/dd/yyyy) Title State ZIP Code (9 Digits) Date of Birth (mm/dd/yyyy) Title State ZIP Code (9 Digits) (IF YOU NEED ADDITIONAL SPACE FOR MORE NAMES, USE ADDITIONAL COPIES OF THIS PAGE.) Page 2 of 4 APPLICATION FOR AIRLINE BEVERAGE PERMIT, CARRIER’S PERMIT, INDUSTRIAL PERMIT, LOCAL INDUSTRIAL ALCOHOL MANUFACTURER’S PERMIT, MARKET RESEARCH PACKAGER’S PERMIT, PASSENGER TRAIN BEVERAGE PERMIT CONTINUED AIRLINE BEVERAGE PERMIT TRADE NAME: FORM L-102 (2/2009) FOR AIRLINE BEVERAGE PERMIT 8A. Do you operate a commercial passenger airplane in compliance with a valid license, permit or certificate issued under the authority of the United States or the State of Texas? B. Give address of location in Texas where records will be kept and available for inspection: 8A. YES NO CARRIER’S PERMIT FOR CARRIER’S PERMIT water carrier airline carrier railway carrier 9A. Specify your classification: B. If a common carrier or motor carrier, indicate under which authority do you operate. (1) Under (Chapter 643, Transportation Code) -OR(2) Under a certificate issued by the Surface Transportation Board. motor carrier C. Give address of location in Texas where records will be kept or indicate, “records will be available for inspection upon request.” \INDUSTRIAL PERMIT FOR INDUSTRIAL PERMIT 10. State fully the nature of business in which applicant is engaged and also state for what purpose alcohol or wine is to be used: LOCAL INDUSTRIAL ALCOHOL MANUFACTURER’S PERMIT FOR LOCAL INDUSTRIAL ALCOHOL MANUFACTURER’S PERMIT NOTE: Plant plans and specifications must be submitted as part of your application. 11A. Do you at this time request permission to store alcohol at a storage facility that is under your control located off the licensed premises? If answer is “YES,” give address of location. B. Have you provided the following: 1. General layout and location of the entire production operation? 2. Specific design of distilling equipment? 3. Detailed plans and specifications of the final production phase? 4. Plans for security precautions to prevent unauthorized beverage use of the production facility? NOTE: Supplemental information will be required if the material submitted is inadequate. Your operation will be subject to continuing review and evaluation. Further modification of equipment or procedure may be required at any time. Any changes or modifications of plant and specifications must be submitted to and approved by this office. C. Describe method or procedure or indicate additive used to render the alcohol unfit for human consumption. 11A. YES NO B1. YES NO 2. YES NO 3. YES NO 4. YES NO Page 3 of 4 APPLICATION FOR AIRLINE BEVERAGE PERMIT, CARRIER’S PERMIT, INDUSTRIAL PERMIT, LOCAL INDUSTRIAL ALCOHOL MANUFACTURER’S PERMIT, MARKET RESEARCH PACKAGER’S PERMIT, PASSENGER TRAIN BEVERAGE PERMIT CONTINUED TRADE NAME: FORM L-102 (2/2009) D1. Do you plan to transport alcohol produced under this permit? D1. YES NO PASSENGER TRAIN BEVERAGE PERMIT MARKET RESEARCH PACKAGER’S PERMIT LOCAL INDUSTRIAL ALCOHOL MANUFACTURER’S PERMIT If “YES,” give method used to transport. -ORGive the following information concerning the vehicles to be used with this permit. D2. (If additional space is needed, attach a page) MAKE MODEL YEAR LICENSE NUMBER FOR MARKET RESEARCH PACKAGER’S PERMIT 12A. Indicate name of permittee from whom your product is received. B. Will the product be received from inside or outside the state? 12B. Inside State Outside State 13A. YES NO B. YES NO FOR PASSENGER TRAIN BEVERAGE PERMIT 13A. Is the applicant corporation organized under Title 112, Revised Statutes or Rail Passenger Service Act of 1970 as amended (45 U.S.C.A. Section 501 et seq.)? B. Does the applicant operate a commercial passenger train service? WARNING: Section 101.69 of the Texas Alcoholic Beverage Code is as follows: “…a person who makes a false statement or false representation in an application for a permit or license or in a statement, report, or other instrument to be filed with the Commission and required to be sworn commits an ACKNOWLEDGMENT offense punishable by imprisonment in the penitentiary for not less than 2 nor more than 10 years.” ACKNOWLEDGMENT If Applicant is: Who Must Sign: Individual Individual Owner Partnership Partner Corporation Officer Limited Partnership General Partner Limited Liability Partnership General Partner Limited Liability Company Office or Manager PRINT NAME: NAME MUST APPEAR AS NAME SHOWN IN QUESTION 7 ON L-102 OR 2 ON L-106-PC SIGN HERE: SIGNATURE MUST APPEAR AS NAME SHOWN IN QUESTION 7 ON L-102 OR 2 ON L-106-PC Before me, the undersigned authority, on this , 20 day of the person whose name is signed to the foregoing application personally appeared and, duly sworn by me, states under oath that he or she read the said application and that all the facts therein set forth are true and correct. SIGN HERE: SEAL NOTARY PUBLIC Page 4 of 4