Macon-Bibb County Business Development Services 682 Cherry Street, Suite 500 Macon, Georgia 31201 Alcoholic Beverage Application Procedures and Instructions New
Liquor Package
Beer Package
Wine Package
Transfer of Location Transfer of Ownership
Liquor Mixed Drinks Draft Beer
Beer C.O.P.
Wine C.O.P.
Liquor Wholesale
Wine Wholesale
Change of Agent
Brown Bagging Beer & Wine
Brown Bagging Beer Liquor & Wine
Manufacture
Corporation and Trade Name
Business Address
Business Telephone
Name of Applicant and/or Agent
Home Address
Home Telephone
Date of Birth
County of Residence
$150.00 Application Fee Applicant and/or Agent Information 1. 2. 3. 4. 5.
Provide Surety License Bond. Current photograph of applicant or agent. Fingerprints of applicant are required. Complete and sign Consent Form for State Wide Check. Provide a valid copy of applicant’s State of Georgia driver’s license. Location Information
1. 2. 3. 4.
Proof of Planning and Zoning compliance. Affidavit from the Macon-Bibb County Engineer’s Department. Legal description of the property upon which premises are located. Affidavit from the Macon Telegraph Newspaper.
I certify that the information disclosed in this application is true and correct, and I agree to abide by, observe, and conduct my business according to the rules and regulations prescribed by Macon-Bibb County, the acts of the Georgia General Assembly, and the State Department of Revenue. _________________________________ Signature of Applicant and/or Agent Date
Macon-Bibb County Alcoholic Beverage Application Instructions
1.
Liquor, Beer, and Wine Beverage bonds require being bonded with an outside insurance agency/company. Use forms included in application.
2.
A current passport size photograph is required. Photo must be of applicant’s face from full frontal view. Driver’s license photo is not acceptable.
3.
Fingerprinting of applicant/agent by the Bibb County Sheriff’s Office (Central Services Unit) is required. Call (478) 803-2341 to schedule an appointment. No walk-ins allowed.
4.
Complete and sign the Consent Form for Statewide Check.
5.
Submit a clear and valid copy of the applicant/agent State of Georgia driver’s license. Applicant MUST be a resident of Bibb County.
6.
Apply at the Bibb Co. Engineer’s Office, 780 Third Street, Macon, GA. 31201, for compliance with distance requirements ($150.00 fee). (478) 6216660.
7.
Zoning Compliance form is required. Contact Macon-Bibb County Planning and Zoning Commission at 682 Cherry St., 9th Floor, Macon, GA 31201 (478) 751-7450. (Additional fee required).
8.
Provide a legal description of the property upon which the premises are located. (Lease Agreement or Property Deed)
9.
An affidavit from the Macon Telegraph located at 487 Cherry Street, confirming an advertisement has run once a week for two consecutive weeks.(478) 744-4200
10.
Return completed application along with a $150.00 Application Fee to Business Development Services 682 Cherry Street, Suite 500 Macon, GA 31201
11.
Prior to returning your application, please verify that all forms have been signed and notarized (if applicable). For your convenience, our office is capable of notarizing Business License documents free of charge. (FOR VERIFICATION PURPOSES- DO NOT SIGN PRIOR TO ARRIVAL. VALID IDENTIFICATION IS REQUIRED)
Applicant will be notified of approval or disapproval of application. Payment for license is due upon approval of application.
Wholesale And/Or Retail Liquor Bond Macon-Bibb County, Georgia State of Georgia, County of Bibb, Bond No. Know all persons by these presents, that PRINCIPAL (Name of applicant/agent)
and
are held and firmly bound unto (NAME OF SURETY COMPANY EXECUTING BOND)
Macon-Bibb County as OBLIGEE in the sum of ONE THOUSAND ($1,000.00) DOLLARS, for the payment of which will and truly be made, we bind ourselves, our heirs, executors, administrators, and successors, as the case may be, jointly, severally and firmly by these presents.
Signed with our hands, and sealed with our seals, this ________ day of _________________, 20_____. WHEREAS, the above named Principal has applied to Macon-Bibb County, Georgia for a license to engage in business at: (Street Address)
(City)
(Trade name of business)
(County)
(State)
(Describe Premises)
As a wholesaler and/or retailer of distilled spirits under the provision the Code of Ordinances, Macon-Bibb County, Georgia, Section 4-23(d)(9), and as hereafter amended for a period beginning the_______________ day of _________________, 20_____, and ending December 31, 20_____. NOW THEREFORE, should said Principal pay all license fees and other expenses required by the Code of Ordinances of Macon-Bibb County, including amendments thereto, and/or rules and regulations promulgated by the Director of Business Development Services, as well as all applicable taxes, and faithfully comply with all laws, rules and regulations governing the sale of liquor as required by aforesaid Code, and any such other regulations as Macon-Bibb County may require, then this bond shall be void; otherwise, to remain in full force and shall be construed a forfeiture bond. This bond shall be cancelled by the Principal, the Surety or the Obligee by giving sixty (60) days notice in writing to each of the other parties hereon at their last known address, but no such cancellation shall affect the liability of either the Principal or the Surety occurring before the expiration date of such notice or date of actual cancellation of said bond. This bond shall be in force for the aforesaid period of said Principal’s liquor license, and shall be deemed to be continued and renewed annually automatically upon the renewal or issue of any liquor license to said Principal for the operation of the aforesaid business at the aforesaid location unless prior to the end of any subsequent calendar year. Said Principal shall notify Macon-Bibb County in writing that their respective obligation herein-under is terminated at the end of each subsequent calendar year. IN WITNESS WHEREOF, the said Principal has hereunto signed and sealed, and the said Surety has caused these presents to be duly executed by its duly authorized officials, or its duly authorized attorney in fact, and its corporate seal to be hereunto affixed, the day and year first written above. Sworn to and subscribed before me this
PRINCIPAL _____________________________________ (Signature Of Applicant / Agent )
_________ day of ___________________, 20____ __________________________________ Notary Public
SURETY _______________________________________ (Attorney In Fact)
NOTE: The official or attorney in fact signing for Surety shall attach to the original bond a certified copy of authority or power to bind the Surety. It shall show that the power is in force and effect at the time of the execution of the bond.
Retailer’s Malt Beverage And/Or Wine Bond Macon-Bibb County, Georgia State of Georgia, County of Bibb, Bond No. ______________________________________________________ Know all persons by these presents, that __________________________________________________________ PRINCIPAL (Name of applicant/agent)
and __________________________________________________________________ are held and firmly bound (NAME OF SURETY COMPANY EXECUTING BOND)
unto Macon-Bibb County as OBLIGEE in the sum of FIVE HUNDRED ($500.00) DOLLARS for the payment of which will and truly be made, we bind ourselves, our heirs, executors, administrators and successors, as the case may be, jointly, severally and firmly by these presents. Signed with our hands, and sealed with our seals, this ____________day of _____________________, 20
.
WHEREAS, the above named Principal has applied to Macon-Bibb County, Georgia for a license to engage in business at: (Street Address) (Trade name of business)
(City)
(County)
(State)
(Describe Premises)
As a retailer of malt or vinous beverages, under the provision the Code of Ordinances, Macon-Bibb County, Georgia, Section 4-23(d)(9), and as hereafter amended for a period beginning the ________________day of _____________________, 20________and ending December 31, 20_________. NOW THEREFORE, should said Principal pay all license fees and other expenses required by the Code of Ordinances of Macon-Bibb County, including amendments thereto, and/or rules and regulations promulgated by the Director of Business Development Services, as well as all applicable taxes, and faithfully comply with all laws, rules and regulations governing the sale of malt or vinous beverages as required by aforesaid Code, and any such other regulations as Macon-Bibb County may require, then this bond shall be void; otherwise, to remain in full force and shall be construed a forfeiture bond. This bond shall be cancelled by the Principal, the Surety or the Obligee by giving sixty (60) days notice in writing to each of the other parties hereto at their last know address but no such cancellation shall affect the liability of either the Principal or the Surety occurring before the expiration date of such notice or date of actual cancellation of said bond. This bond shall be in force for the aforesaid period of said Principal’s malt beverage license, and shall be deemed to be continued and renewed annually automatically upon the renewal or issue of any malt beverage license to said Principal for the operation of the aforesaid business at the aforesaid location. Said principal shall notify Macon-Bibb County in writing that their respective obligation herein-under is terminated at the end of each subsequent calendar year. IN WITNESS WHEREOF, the said Principal has hereunto signed and sealed, and the said Surety has caused these presents to be duly executed by its duly authorized officials, or its duly authorized attorney in fact, and its corporate seal to be hereunto affixed, the day and year first written above. Sworn to and subscribed before me this
PRINCIPAL _____________________________________ (Signature Of Applicant / Agent)
_____ day of _____________, 20____ _______________________________ Notary Public
SURETY _______________________________________ (Attorney in Fact)
NOTE: The official or attorney in fact signing for Surety shall attach to the original bond a certified copy of authority or power to bind the Surety. It shall show that the power is in force and effect at the time of the execution of the bond.
Macon-Bibb County Alcoholic Beverage License Application Check All That Apply: New
Transfer-Location
Transfer-Ownership
Change of Agent
BUSINESS INFORMATION
Trade Name Corporate Name Federal/State Taxpayer Identification Number Street Address Mailing Address Telephone Number APPLICANT / AGENT INFORMATION
Name Residential Street Address Mailing Address Telephone Number Date of Birth
Social Security Number
The undersigned certifies that the information contained in this application and accompanying documentation is true and correct. The undersigned further agrees to abide by, observe and conduct the licensed business according to all county ordinances and state laws and regulations in respect thereof. _____________________________________ Agent’s Signature
____________________ Date
I hereby certify that signed his/her name to the forgoing statement after stating to me under oath administered by me, that all statements and answers are true and correct. This
day of
, 20____ Notary Public
OWNERS INFORMATION FORM Type or print clearly A separate copy of this form must be completed for each individual who has an interest in the business as owner, partner, or principal stockholder. Local ordinance prohibits the issuance, renewal, or transfer of an alcoholic beverage license to any person where an individual having an interest either as owner, partner, or principal stockholder has been convicted of pled nolo contender within ten (10) years immediately prior to the filing of the application for any felony or convicted of two (2) or more misdemeanors of any state in the United States or any municipal ordinance (except traffic violations) within two (2) years. The Bibb County Sheriff’s Office will conduct a nationwide criminal background check of the individual named herein and report its findings to Business Development Services. Date of Application: Business: Trade Name Name of Corporation Individual: Name Residential Street Address Mailing Address Telephone Number (
)
Date of Birth
Social Security Number
Interest in Business: Check the Applicable Description The business is a publicly held corporation, and the above named individual owns Ten percent (10%) or more of the business Less than ten percent (10%) of the business The business is not a publicly held corporation, and the above individual owns Percent of the business.
Name-Based Criminal History Record Information Consent/Inquiry Form I hereby give consent for the _BIBB SHERIFF’S OFFICE__ to conduct an inquiry and receive any Georgia criminal history record information pertaining to me which may be contained in the files of any state or local criminal justice agency in Georgia. Full Name (print): Address: Sex
Race
Date of Birth
Social Security Number
This authorization is valid for 90/180/______ (circle one) days from date of signature. I, __________________________________________ give consent to the above name to perform periodic criminal history background checks for the duration of my employment with this company. _______________________________________________________ Signature
________________________ Date
Date of Inquiry:_____________ Time of inquiry:_____________ Operator’s initials:__________ Purpose Code used: (check one) Employment (E) - Provides Georgia Criminal History Record Information Employment with Mentally Disabled (M) – Provides Georgia Criminal History Record Information Employment with Elder Care (N) – Provides Georgia Criminal History Record Information Employment with Children (W) – Provides Georgia Criminal History Record Information Public Records (P) – Provides Georgia Felony Convictions Only
The inquiry resulted in the following: (check all that apply) No Georgia CHRI results available. Georgia CHRI attached/released. No NCIC/GCIC Warrant results available. Possible NCIC/GCIC Warrant. Contact Agency listed below. Wanting Agency Name: Agency Telephone: ________________________________________________ Agency Designee Signature and Title
__________________ Date
MACON-BIBB COUNTY, GEORGIA SYSTEMATIC ALIEN VERIFICATION FOR ENTITLEMENTS (SAVE) PROGRAM O.C.G.A. § 50-36-1 (e) (2) Affidavit NOTE: O.C.G.A. § 50-36-1 defines an applicant as “any natural person, 18 years of age or older, who has made application for access to public benefits on behalf of an individual, business, corporation, partnership, or other private entity.” O.C.G.A. § 50-36-1 provides a list of public benefits for which alien verification is required. Included in the list of public benefits at O.C.G.A. § 50-36-1 is “a state or local benefit as defined in 8 U.S.C. Section 1621,” which specifically includes “any grant,…loan, professional license, or commercial license provided by an agency of a State or local government or by appropriated funds of a State or local government.” By executing this affidavit under oath, as an applicant for one of the enumerated benefit as referenced in O.C.G.A. § 50-36-1 and 8 U.S.C. 1621 from Macon-Bibb County, Georgia, the undersigned applicant verifies one of the following with respect to my application for a public benefit: 1) ____I am a United States citizen. 2) ____I am a legal permanent resident of the United States. 3) ____I am a qualified alien, non-immigrant under the Federal Immigration and Nationality Act with an alien number issued by the Department of Homeland Security or other federal immigration agency. My alien number issued by the Department of Homeland Security or other federal immigration agent is: ______________________________.
The undersigned applicant also hereby verifies that he or she is 18 years of age or older and has provided at least one secure and verifiable document (i.e. valid driver’s license or passport), as required by O.C.G.A. § 50-36-1 (e) (1), with this affidavit. The secure and verifiable document provided with this affidavit can best be classified as: _____________________________________________________________________.
In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of O.C.G.A. § 1610-20, and face criminal penalties as allowed by such criminal statute.
Executed in _____________________ (City),_____________________(State)
___________________________________ Printed Name of Applicant
_______________________________________ Signature of Applicant
SUBSCRIBED AND SWORN BEFORE ME ON THIS _____DAY OF ________________________, 20___
___________________________________________ NOTARY PUBLIC
Commission Expires: ___________________
