Non Resident Liquor License Application

New Mexico Regulation and Licensing Department T on ey An a ya Bu i ld in g P O Box 251 01 Sa nt a F e, N ew Mexi co 87504- 51 01 ( 505) 476- 4875 F ax (505) 476- 4595 www.r ld .st at e.nm.u s/ a lco ho lan d gam in g ALCOHOL AND GAMING DIVISION NON-RESIDENT LIQUOR LICENSE APPLICATION APPLICATION FEE IS $200.00, IN ADDITION TO THE CALCULATED FEE LISTED BELOW. Applicant must submit the Total amount due. All fees are non-refundable. 3 YEAR PRO-RATED LICENSE FEES: Pursuant to New Mexico State Statute §60-6A-16D, which states: Nonresident licenses and common carrier registrations shall be issued for a three-year period. The three-year license for nonresident licenses and for common carrier registrations begins July 1, 2013 and every third year subsequently. Nonresident licenses and common carrier registrations issued at any time during the: (1) first license year shall be subject to payment of the full amount of the three-year license fee; (2) second license year shall be subject to payment of two-thirds of the three-year license fee; and (3) third license year shall be subject to payment of one-third of the three-year license fee. find the estimated total billing to New Mexico Wholesalers in the first column, then select the fee from the appropriate License Period column. For example, if estimated total billing annually is $100,000 and the license period you are applying in is covered by the dates 07/01/17 to 06/30/19, the fee is $1200. Remember to add the $200 Application Fee to the Pro-rated License Fee. TO CALCULATE YOUR FEE, LICENSE PERIOD LICENSE PERIOD LICENSE PERIOD TOTAL BILLING $49,999 annually or less $50,000 annually $100,000 annually $200,000 annually $500,000 annually $1,000,000 annually $3,000,000 annually 07/01/2016 to 06/30/2019 $300 $900 $1,800 $2,700 $3,750 $5,250 $10,500 07/01/2017 to 06/30/2019 $200 $600 $1,200 $1,800 $2,500 $3,500 $7,000 07/01/2018 To 06/30/2019 $100 $300 $600 $900 $1,250 $1,750 $3,500 NMSA§60-7A-4. Sale, shipment and delivery unlawful. A. It is unlawful for any person on his own behalf or as the agent of another person, except a licensed New Mexico wholesaler or manufacturer or the agent of either, to directly or indirectly sell or offer for sale for shipment into the state or ship into the state, any alcoholic beverages unless such person or his principals has secured a nonresident license. NMSA§60-8A-6. Primary American Source of Supply. For the purpose of tax revenue control, no holder of a nonresident license or resident broker license may solicit, accept or fill an order for distilled spirits or wine from a holder of any type of wholesaler's license unless the nonresident licensee or resident broker is the primary American source of supply for the brand of distilled spirits or wine that is ordered. As used in this section, "primary American source of supply" means the distiller, the producer, the owner of the commodity at the time it becomes a marketable product, the bottler or the exclusive agent of any of those. To be the "primary American source of supply," the nonresident licensee or resident broker must be the first source, that is, the manufacturer or the source closest to the manufacturer, in the channel of commerce from whom the product can be secured by American wholesalers. Revised 7/14/2016 American LegalNet, Inc. www.FormsWorkFlow.com New Mexico Regulation and Licensing Department T on ey An a ya Bu i ld in g P O Box 251 01 Sa nt a F e, N ew Mexi co 87504- 51 01 ( 505) 476- 4875 F ax (505) 476- 4595 www.r ld .st at e.nm.u s/ a lco ho lan d gam in g ALCOHOL AND GAMING DIVISION NON-RESIDENT LIQUOR LICENSE APPLICATION AGD USE ONLY: Application No. _______________________________ License No. ________________________ Applicant (Individual, Corporation, LLC, etc.): ____________________________________________ DBA: ________________________________________________________________________ Mailing Address: _______________________________________________________________ Physical Location: ______________________________________________________________ Phone Number: __________________________ Fax Number: E-mail:________________________________________________________________________ Contact Person:_________________________________________________________________ Estimated annual gross billings to New Mexico Wholesalers $ Name and license number of New Mexico Wholesaler that will be distributing this product: List every Liquor License in which the Applicant holds any direct or indirect interest: I, the undersigned, swear that I am authorized, under the active License attached, to obtain this permit and that the information on this application form is true and correct, to the best of my knowledge. I have also attached the following, with all required documents, in the name of Applicant: $200 Application Fee & the 3 Year Pro-rated License Fee (See Page 1 to calculate) $200.00 + $ ___________________= Total Fee submitted: $_____________________ Copy of Manufacturer or Wholesaler License, from the state in which you are licensed Primary American Source of Supply Letter, if applicable Copy of the Federal Basic Permit or Brewer's Notice (APPLICANT, PLEASE NOTE: Copies of label approvals must be submitted to http://productregistrationonline.com and AGD no longer accepts hardcopies or Digital copies on CD ) Print Name: ___________________________________________ Title: __________________ Authorized Signature: ___________________________________ Date: __________________ ALCOHOL & GAMING DIVISION USE ONLY: Payment| Application Fee $_______________ Received on: _______________ Receipt No. __________________ Approved Disapproved, ________________________________________________________________ Processed By: __________________________________________________ Date: _________________________ License /Renewal Sent on: ____________________________ By: Email 1st class mail Fax New M ex i c o R eg ul at i o n and L ic ens in g D epar t men t AL C OH OL AN D GA M I NG D I VI SI O N Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Revised 7/14/2016