Teen Night Notification

ALCOHOL FREE TEEN EVENTS On-premises licensees planning alcohol free teen events are required by law to notify the State Liquor Authority (SLA) in writing 10 days prior to holding such activity at their establishment. The Authority has promulgated a notification form which can be downloaded from this site for submission to the appropriate SLA Zone Office by either fax or mail. It is not necessary that you use this form, but your written notification must contain all the required information. The following are the addresses and fax numbers for the SLA Office in your zone. To locate your county area, go to Licensing Information and click on "Where Do I File?" ZONE I ­ NEW YORK CITY New York State Liquor Authority 317 Lenox Avenue New York, New York 10027 Attn: Enforcement Bureau Fax: (212) 961-8381 ZONE II ­ ALBANY/SYRACUSE DISTRICT New York State Liquor Authority 80 S. Swan St., Suite 900 Albany, New York 12210 Attn: Enforcement Bureau Fax: (518) 473-7527 ZONE III- BUFFALO New York State Liquor Authority 535 Washington St., Suite 303 Buffalo, New York 14203 Attn: Enforcement Bureau Fax: (716) 845-5020 Remember: During the teen event(s), no alcoholic beverages shall be sold, served, given away or consumed by any persons at the establishment. If you decide to cancel the teen event after the written notification was submitted, you must contact both the police and the SLA as soon as possible prior to that date. American LegalNet, Inc. www.FormsWorkflow.com TEEN NIGHT NOTIFICATION Notice must be filed in writing at least 10 days prior to event(s) As required by Section 260.21.1.(d), I hereby notify the New York State Liquor Authority of the closing of my establishment to the public for a specified period of time to conduct an activity or entertainment, during which a child (less than 16 years of age) is in or remains in my establishment and no alcoholic beverages are sold, delivered, given away or consumed at my establishment during such period. Premises License Number Premises Name: Dba: Address: Contact Person: Telephone Number: Type of Event 1 2 3 4 5 6 7 8 9 10 On ____________________________ (date), I submitted a completed copy of this notice to the _______________________________________ (name of police department) in my locality. Date Start Time / Ending Time County I will contact the above police department and the New York State Liquor Authority in advance of any changes (10 days prior) or cancellations to the above scheduled events. Print Name Signed: Title: American LegalNet, Inc. www.FormsWorkflow.com