Provisional Permit Agreement

DCPLC - PROVISIONAL PERMIT AGREEMENT FORM. This form is used by the Liquor Control Division of the Connecticut Department of Consumer Protection. This form is to be completed by individuals or entities applying for a provisional liquor permit in the state of Connecticut. The form includes instructions on how to fill it out and submit it along with the liquor permit application. It requires the applicant to provide their trade name, proposed premises address, backer legal entity name, and other relevant details. Section A of the form pertains to the request and stipulated agreement for the provisional permit. The applicant acknowledges the additional $500 fee required for the provisional permit and understands that the fee is nonrefundable. They also agree that the provisional permit will expire after 90 days, and if they are not approved for a final liquor permit before the expiration, they will have no right to sell alcohol unless an extension is granted. Section B of the form allows the applicant to request approval for wholesalers to extend credit while operating under the provisional permit. The applicant may need to provide proof of fiscal responsibility, such as a financial statement and supporting documentation. The form concludes with a certification statement where the applicant acknowledges the fee requirement, the expiration and extension provisions of the provisional permit, and affirms the truthfulness of the information provided. It's important to note that this form is specific to the liquor control regulations of Connecticut and should be used in conjunction with the relevant laws and guidelines provided by the Department of Consumer Protection. www.FormsWorkflow.com