Solicitor Salesman Permit Application

VIRGINIA DEPARTMENT OF ALCOHOLIC BEVERAGE CONTROL 2901 Hermitage Road - P O Box 27491 - Richmond VA 23261-7491 APPLICATION FOR SOLICITOR SALESMAN PERMIT A permit is required to solicit or promote wine or beer to wholesale or retail licensees by a wine or beer solicitor salesman or representative of any out-of-state wholesaler engaged in the sale of wine or beer. Such permits shall not authorize the sale of wine or beer by the permittee, the direct solicitation or receipt of orders for wine or beer, or the negotiation of any contract or contract terms for the sale of wine or beer unless such sale, receipt or negotiations are conducted in the presence of a licensed Virginia wholesaler or importer or such Virginia wholesaler' or importer' salesman or representative. s s Applicant must be 18 years of age or older and may not be employed at the same time by an out-of-state wholesaler engaged in the sale of wine or beer and by a licensee to solicit the sale of or sell wine or beer.. There is a $165 annual fee for this permit which is prorated quarterly. July 1 thru September 31 - $165; October 1 thru December 31 - $123.75; January 1 thru March 31 - $82.50; and April 1 thru June 30 - $41.25. All permits expire June 30th of each year and the renewal fee is $165. * A permit is required for any person having interest in the manufacture, distribution or sale of spirits or other alcoholic beverages to solicit any mixed beverage licensee, his agent, employee or any person connected with the licensee in any capacity in his licensed business to sell or offer for sale such spirits or alcoholic beverages. [§4.1-212 (2), Code] Applicant must be 21 years of age or older. There is a $390 annual fee for this permit which is prorated quarterly. July 1 thru September 31 - $390; October 1 thru December 31 $292.50; January 1 thru March 31 - $195; and April 1 thru June 30 - $97.50. All permits expire June 30th of each year and the renewal fee is $390.* In addition to completing the application, applicants for distilled spirits solicitor salesman permits, must submit a letter, on company letterhead, of authorization from the manufacturer, brand owner or its duly designated United States agent, of each specific brand(s) of distilled spirits which the permittee is authorized to represent on behalf of the manufacturer or brand owner in the Commonwealth. - Type or print legibly with black ink. Answer questions completely and accurately. Mail or deliver the completed application with appropriate fee(s) to: Department of Alcoholic Beverage Control License Records Management 2901 Hermitage Road P O Box 27491 Richmond, Virginia 23261-7491 Upon receipt of the completed application, required fees and authorization; the application will be processed and a permit will be forwarded to the applicant. Such permit shall be carried at all times while on official business and must be presented to ABC agents and other police officers upon request. * For a combined Wine, Beer and Distilled Spirits Solicitor Salesman Permit there is a $555 annual fee which is prorated quarterly. July 1 thru September 31 $555; October 1 thru December 31 - $416.25; January 1 thru March 31 - $277.50; and April 1 thru June 30 $138.75. All permits expire June 30th of each year and the renewal fee is $555. 805-81: Rev. 6/2004 American LegalNet, Inc. www.FormsWorkflow.com 2901 Hermitage Road ? P O Box 27491 ? Richmond VA 23261-7491 APPLICATION FOR SOLICITOR-SALESMAN PERMIT COMPANY INFORMATION Company Name Street Address City Telephone Number (Please check appropriate box) q Wine and Beer Solicitor Salesman Permit State Fax Number Zip TYPE OF PERMIT Fee Amount Submitted Fee Amount Submitted There is a $165 annual fee for this permit which is prorated quarterly. July 1 thru September 31 - $165; October 1 thru December 31 - $123.75; January 1 thru March 31 - $82.50; and April 1 thru June 30 - $41.25. All permits expire June 30th of each year and the renewal fee is $165. q Distilled Spirits Solicitor Salesman Permit There is a $390 annual fee for this permit which is prorated quarterly. July 1 thru September 31 - $390; October 1 thru December 31 - $292.50; January 1 thru March 31 - $195; and April 1 thru June 30 - $97.50. All permits expire June 30th of each year and the renewal fee is $390. q Wine, Beer and Distilled Spirits Salesman Permit Fee Amount Submitted There is a $555 annual fee for this permit which is prorated quarterly. July 1 thru September 31 - $555; October 1 thru December 31 - $416.25; January 1 thru March 31 - $277.50; and April 1 thru June 30 - $138.75. All permits expire June 30th of each year and the renewal fee is $555. APPLICANT INFORMATION Last Name Date of Birth / / First Name Social Security Number Middle Name / / MAILING ADDRESS FOR PERMIT Street Address City State Zip APPLICANT SIGNATURE I certify that the information provided is true and correct to the best of my knowledge and belief: Signature Name and Title(please print) ABC USE ONLY Amount Paid Receipt Date Receipt # Solicitor Permit # American LegalNet, Inc. www.FormsWorkflow.com