Application For Carriers Alcoholic Permit {47242}

APPLICATION FOR CARRIER'S ALCOHOLIC PERMIT State Form 47242 (R / 6-14) I Form 601 Approved by State Board of Accounts, 2014 ALCOHOL AND TOBACCO COMMISSION 302 West Washington Street, Room E114 Indianapolis, IN 46204 Website: www.in.gov/atc NOTE: This application must be filed and accompanied by the proper fee of $5.00 / Cashier's Check, Certified Check, or Money Order. Permit number (if renewal) To the Indiana Alcoholic and Tobacco Commission: The undersigned ______________________________________________________________ (Type full name of applicant.) individual general partnership corporation limited partnership limited liability corporation hereby makes application for a Carrier's Alcoholic Beverage Permit to entitle said applicant to haul, convey, move, transport or import alcoholic beverages along or over the public highways of this state, under and subject to the provisions of Indiana Code 1971, I.C. 7.1-3-18-1 through 7.1-3-18-6. The applicant consents, that for the duration of the permit term, if issued, to the entrance, inspection and search by a law enforcement officer, without a warrant or other process of his licensed premises and vehicles within Indiana to determine whether he is complying with the provisions of the alcoholic beverage laws and rules and regulations of Indiana. The applicant further consents to keep the proper identification tag or label displayed upon each motor vehicle to which this application applies, and the descriptions of which are attached hereto and made a part hereof, and also upon each motor vehicle registered with the Commission under this permit. The applicant further states, and warrants as true, the descriptions of motor vehicles desired to be covered by this permit as attached hereto and likewise warrants as true the following information: 1. If the applicant is an individual or general partnership, state name and residence address of yourself and each partner: Address (number and street, city, state, and ZIP code) Address (number and street, city, state, and ZIP code) Address (number and street, city, state, and ZIP code) Name Name Name 2. If the applicant is a corporation, limited partnership or limited liability company, give date of incorporation or organization, state in which incorporated or organized, and location of principal place of business: State in which incorporated Telephone number Date of incorporation (month, day, year) Address of principal place of business (number and street, city, state, and ZIP code) ( 3. ) If a corporation, of all the following that apply limited partnership or limited liability company, give names and addresses of president, secretary, resident agent: Address (number and street, city, state, and ZIP code) Address (number and street, city, state, and ZIP code) Address (number and street, city, state, and ZIP code) Address (number and street, city, state, and ZIP code) Address (number and street, city, state, and ZIP code) Address (number and street, city, state, and ZIP code) Address (number and street, city, state, and ZIP code) Address (number and street, city, state, and ZIP code) Address (number and street, city, state, and ZIP code) Name of president Name of secretary Name of registered agent Name of general partner(s) Name of LLC members Name of limited partner(s) Name Name Name 4. How long have you been engaged in the business of a common carrier, or carrier for hire? 5. How many vehicles or conveyances do you operate in connection with your business, including the transportation of merchandise other than alcoholic beverages? Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 6. If you do not own all the vehicles, give names and addresses of owners and state fully your interest in such vehicle or vehicles and the nature of the arrangements between yourself and the owner thereof: 7. I have read, understand and have made true answers to each of the above questions. Date (month, day, year) Signature of applicant (if individual) or corporate or partnership name By: (Signature of officer, agent or partnership) State of ____________________________________ SS: County of __________________________________ Subscribed and sworn to before me by the above named ________________________________________________________________________________________________________________________ (Name of individual, officer, agent or partner) this ______ day of ________________________, 20______. Signature of notary County of residence Typed or printed name of notary Date commission expires (month, day, year) SEAL SECTION 7.1-3-18-1 7.1-3-18-2 7.1-3-18-3 7.1-3-18-4 CHAPTER 18 - SPECIAL PERMITS SECTION 7.1-3-18-5 Prerequisite to issuance of carrier's alcoholic permit Carrier's alcoholic permit - Issuance authorized. Vehicle description. Scope of carrier's alcoholic permit. 7.1-3-18-7 Salesman's permit - Issuance authorized - Application Highway transportation - Carrier's permit required. Contents Beer for consumption out of state - Carrier's permit not 7.1-3-18-8 Scope of salesman's permit. required. 7.1-3-18-1. Carrier's alcoholic permit - Issuance authorized. The commission may issue a carrier's alcoholic permit to a person who is a carrier upon a showing of the reliability and responsibility of the carrier and the propriety of issuing the permit. The commission may issue a carrier's alcoholic permit without publication of notice and investigation by a local board. [IC 7.1-3-18-1 , as added by Acts 1973, P.L. 55 & 1.) 7.1-3-18-2. Scope of carrier's alcoholic permit. A carrier's alcoholic permit shall be required only for, and be applicable to, the movement, conveyance, importation and transportation of alcohol and alcoholic beverages on a public highway in this state. A carrier's alcoholic permit shall not be required when the conveyance, movement, importation, or transportation is conducted by means of cars or trains operated by a railroad of any type over fixed rails. [IC 7.1-3-18-2, as added by Acts 1973, P.L. 55 & 1) 7.1-3-18-3. Highway transportation - Carrier's permit required. A carrier shall be required to apply for and obtain a carrier's alcoholic permit before he may haul, convey, transport or import alcoholic beverages on a public highway of this state or crossing a boundary of it. [IC 7.1 -3-17-3, as added by Acts 1973, P.L. 55 & 1.) 7.1-2-18-4. Beer for consumption out of state- Carrier's permit not required. A carrier who transports beer manufactured in Indiana for consumption outside this sta