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Beer and Wine Privilege Business License Application

  1. BEER & WINE BUSINESS LICENSE APPLICATION
  2. Type of Application*
  3. Is a copy of your ABC Permit attached?
  4. Does your business have a valid City of Durham Privilege License?
  5. Check all that apply
  6. This application is for the sale of beer and/or wine at retail. The undersigned applicant for license to sell beer and/or wine states that the answers to the following questions are true of his/her own knowledge and are made for the purpose of inducing the City Council of the City of Durham to issue a license to the undersigned for the sale of such alcoholic beverages as indicated within the corporate limits of the City of Durham.
  7. BUSINESS INFORMATION
  8. Include DBA if applicable
  9. Include any suite or apartment #. DO NOT use a PO Box.
  10. BUSINESS OWNER'S INFORMATION
  11. In North Carolina (Years)
  12. Are you a citizen of the United States?
  13. (Years)
  14. Have you ever been convicted of a felony or crime involving moral turpitude?
  15. Have you ever been convicted of violating the Federal or State prohibition laws?
  16. If YES, were you convicted at any time within the past two years?
  17. Did you complete serving a sentence for any such violation during the past two years?
  18. Have you had any license to sell alcoholic beverages revoked during the past five years?
  19. Provide as much detail as possible
  20. As the present owner of this business, do you intend to operate this business yourself?
  21. As the present owner of this business, do you intend to operate this business under your immediate supervision and direction?
  22. To your knowledge, have any of the persons named in this application been convicted of any felony or crime involving moral turpitude, or of violation of the State or Federal Prohibition Laws?
  23. BUSINESS MANAGER or OPERATOR OF BUSINESS
  24. PREVIOUS OWNER of BUSINESS INFORMATION
  25. OWNER of PREMISES
  26. REFERENCES
    Names and contact information of individuals whom you are not associated with in business.
  27. As a further inducement to the City Council of the City of Durham, the owner agrees that he/she will promptly report any change or condition that may affect the validity of the information provided above.
  28. ELECTRONIC SIGNATURE AGREEMENT
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  29. I agree with the Electronic Signature Agreement*
  30. Person making application
  31. Person making application
  32. Leave This Blank:

  33. This field is not part of the form submission.