Promotional Permit {L-PR}

P.O. Box 13127, Austin, Texas 78711-3127 (512)206-3333 www.tabc.state.tx.us An Equal Opportunity Employer FORM L-PR-I (01/201) INFORMATION AND INSTRUCTIONS FOR PROMOTIONAL PERMIT PROMOTIONAL PERMIT 226 This permit authorizes the holder to engage in activities to promote and enhance the sale of an alcoholic beverage in this state, including activities that take place on the premises of the holder of a permit or license under this code, on the behalf of a distiller, brewer, rectifier, manufacturer, winery, or wine bottler with whom the promotional permit holder has entered into a contract for the purposes of Chapter 50 of the Texas Alcoholic Beverage Code. The State fee is $600 with a surcharge of $376 and the permit will expire two years from date of issuance. In additions, the Promotional Permit may only be issued if the applicant/entity provides: A copy of all contracts with licensed or permitted entities to the Texas Alcoholic BeverageCommission Licensing Division in Austin prior to the promotional event An employment card to all agents, servants, or employees that are participating in promotionalevent this card must contain: name of employee, agent or servant, effective date of employment,name of the promotional permit holder, and the promotional permit number. The aforementionedcard must be kept on the person during promotional events and available for inspection by anyauthorized representative of the Texas Alcoholic Beverage CommissionAffirmation that the applicant does not directly or indirectly have any financial interest in an entityholding a permit or license issued by the Texas Alcoholic Beverage Commission other than acontract to promote and enhance the sale of alcoholic beverages Be advised that the Promotional Permit holder, including the agent, servant, or employee, may NOT hold any other permit issued by the Texas Alcoholic Beverage Commission, including an Agent222s Permit, Agent222s Beer License, and a Manufacturer222s Agent222s Permit. The permit covered under this form will be issued for a two-year period. You MUST renew for the entire two-year period. 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 cashier222s check, money order, or firm check from corporate permittee payable to the Comptroller of Public Accounts. If you need additional information, please do not hesitate to contact this office at (512) 206-3360. Sample Employment Card Promotional Permit Employee ID Card Name of Employee: Effective Date of Employment: Name of Promotional Permit Holder: Promotional Permit Number: PR- American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 3 Form L-PR (01/201) APPLICATION FOR PROMOTIONAL PERMIT (PR) L-PR (01/201) TABC USE ONLY PR - ISSUE DATE FEE SURCHARGE TOTAL $600 $376 Registry No. 1.APPLICANT IS FILED FOR: Individual Corporation Limited Liability Company Partnership Limited Partnership Limited Liability Partnership Other 2. Trade Name of Business 3. Mailing Address City State Zip Code (9 digits) Address of Location City State Zip Code (9 digits) 4. Business P hone No. A lternate P hone No. 5 . E - Mail Address : INDIVIDUAL OWNER 6.Social Security Number Issuing State /Driver License Number Date of Birth (mm/dd/yyyy) Full Legal Name (Last, First, Middle) Residential Address City State Zip Co de (9 digits) TABC USE ONLY INITIAL APPLICATION INCOMPLETE YES - NO ADDITIONAL CORRESPONDENCE YES - NO PROCESSOR REVIEW DATE: / / PROCESS DATE: / / PROCESSOR I.D.: PROCESSOR ERROR YES - NO American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 3 Form L-PR (01/201) REPORTING OWNERSHIP If multiple levels of ownership, use this form to disclose each entity at each level. Use additional copies if necessary to disclose each level. If applicant is a partnership, 100% of the interest in the partnership must be accounted for among the partners listed. If one or more of your general or limited partners is a limited partnership or limited liability partnership, complete an additional section of question 7 for each partnership. If one or more of your general or limited partners is a corporation, complete question 7 for each corporation or Limited Liability Company. If applicant is a corporation and stockholder is corporation, provide pertinent information as indicated in question 7F. PARTNERSHIP S / CORPORATIONS / LIMITED LIABILITY COMPANY 7A. Indicate type of ownership and complete the information below: Corporation Limited Liability Company Partnership Limited Partnership Limited Liability Partnership B. Federal Employer222s I.D. No.: C. Entity Name: D. Filing No.: Date Approved State E. Number and class of shares, memberships or units issued: F.COMPLETE THE FOLLOWING FOR REPORTING OWNERSHIP : Social Security Number Issu ing State/ Driver222s License Number Date of Birth (mm/dd/yyyy) Class & No. of Shares, Memberships or Units Held Full Legal Name (Last, First, Middle) Officer Director/ Manager Stockholder/Member Position/Title Residential Address City State ZIP Code (9 digits) Social Security Number Issuing State/ Driver222s License Number Date of Birth (mm/dd/yyyy) Class & No. of Shares, Memberships or Units Held Full Legal Name (Last, First, Middle) Officer Director/ Manager Stockholder/Member Position/Title Residential Address City State ZIP Code (9 digits) Social Security Number Issuing State/ Driver222s License Number Date of Birth (mm/dd/yyyy) Class & No. of Shares, Memberships or Units Held Full Legal Name (Last, First, Middle) Officer Director/ Manager Stockholder/Member Position/Title Residential Address City State ZIP Code (9 digits) Social Security Number Issuing State/ Driver222s License Number Date of Birth (mm/dd/yyyy) Class & No. of Shares, Memberships or Units Held Full Legal Name (Last, First, Middle) Officer Director/ Manager Stockholder/Member Position/Title Residential Address City State ZIP Code (9 digits) (IF MORE SPACE IS NEEDED, USE ADDITIONAL COPIES OF THIS PAGE.) American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 3 Form L-PR (01/201) ALL APPLICANTS Per chapter 50 of the Texas Alcoholic Beverage Code, The applicant or holder of a Promotional Permit MAY NOT hold an interest, directly or indirectly, in an entity holding another permit or license issued by the Texas Alcoholic Beverage Commission. You or your agent, servant or employee MAY NOT be employed in any capacity by a permit/license holder except for the contract to promote and enhance alcoholic beverages for promotional events. 8 . Are you or anyone named in questions 6 or 7F, or your agent, servant or employee in violation of the above requirements? If 223YES,224 explain below or attach page: 8. YES NO 9 A. Ha s any person named in question 6 or 7F , or his or her spouse b een finally convicted or received deferred adjudication for a felony offense? 9 A. YES NO B. If answer to 9 A is 223YES,224 has it been five years since the termination of a sentence, parole or probation served for any offenses indicated above? If answer to 9B is 223NO,224 attach an explanation. B. YES NO C. Has any p erson named in question 6 or 7F been convicted of any offense(s) under federal or state law, or municipal ordinance involving violations of an individual222s civil rights or discrimination against an individualon the basis of race, color, creed or national origin? C. YES NO 10 . I affirm that I will provide copies of all contracts wi th licensed/permitted entities to the Texas Alcoholic Beverage Commission Licensing Division in Austin prior to the promotional event. 10 . YES NO 11 . I affirm that all agents, servants, or employees that are partic ipating in promotional events will be provided with employment cards and that these cards must be kept on the person during promotional events andavailable for inspection by any authorized representative of the Texas Alcoholic Beverage Commissioncontaining: The name of the promotional permit holder,The Promotional Permit number,Name of employee, agent or servant, E ffective date of employment. 11. YES NO ACKNOWLEDGMENT WARNING: Section 101.69 of the Texas Alc oho