Application for Small Business Liquor License

Classification
- select - Brewpub Micro-brewery Restaurant Bar Taproom

Type of Business
- select - Individual Corporation Partnership Other

Corporation Name
True Name of LLC or Individual Name or Partnership Name (can be same as Establishment Name)

Corporation / LLC or Partnership Federal EIN Number

Legal Description of Premises

Name and address of owner of building in which licensed business is to be conducted

Full Name

Address

Cellphone

Email

Date of Birth

Place of Birth (City, State, Country)

Please list all other legal names you have used, if any

Please provide the name, age and occupation of your next of kin.
An issued license will be transferred to this person should death or incapacitation occur.

Has applicant ever possessed a beer or liquor license?
- select - Yes No Maybe

Has the applicant ever been employed by an entity that held a liquor license?
- select - Yes No

Has applicant / next of kin ever been arrested and charged with a violation of liquor law?
- select - Yes No

Has applicant / next of kin ever been arrested and charged with a felony?
- select - Yes No

Does the applicant have any other license(s) to sell beer / liquor?
- select - Yes No

Does the applicant have any interest, financial or otherwise, in any other beer or liquor license?
- select - Yes No

Extent of Interest

Is applicant indebted in any way for money or property proposed to be used in the licensed business?
- select - Yes No

Name of recipient in debt to

Address of recipient in debt to

Amount of money in debt

Business or occupation of recipient whom in debt to

Provide current personal property tax jurisdiction and receipt number
If you have a waiver, please upload the Waiver document or visit the Excise Department with the document in hand.
- select - City County Waiver

County tax receipt number

City tax receipt number

Has there been any change in managing officer, corporate officers, stockholders or stock ownership which has not been approved by the Excise commissioner?
- select - Yes No

Enter the name, address, date of birth, place of birth and number of shares of stock now owned by each officer or stockholder.

Has any officer or stakeholder been arrested or charged with any violation of the liquor laws or any felony?
- select - Yes No

Has any officer or shareholder any direct or indirect interest, financial or otherwise, in any other beer or liquor licenses?
- select - Yes No

We accept .gif,.jpg,.jpeg,.png,.tiff,.bmp,.pdf,.txt,.rtf,.csv,.doc,.docx,.xls,.xlsx,.ppt,.pptx, .zip files under 50 MB. check total requried

The system allows you to upload a maximum of 20 documents with your application. You may upload more documents via case manager after you submit.

Add another related document

I understand that false answers are grounds for denial of a license.

I understand that if any statement or answers made herein are untrue and the license herein applied for is granted, such license may be revoked, suspended and/or canceled by the Excise Commissioner.

I understand and acknowledge that any license granted by the City of St. Louis will be subject to the provisions of Ordinance 71819 and any other applicable amendments.

I understand that any failure to conform to these aforementioned amendments or provisions will be subject its license to suspension, revocation, and/or fine by the Excise Commissioner.

I allow inspections made in accordance with Ordinance 71819 and authorize the Excise Commissioner and their duly appointed Agents to examine and secure all business records related to the operation.

I authorize the Excise Commissioner and/or their duly appointed agents to secure copies of any and all financial records, including without limitation, any financial documents related to the business.

I authorize the Excise Commissioner or their duly appointed agents to conduct a criminal record check of the owner, all partners, managing officer, all officers and stockholders owning 10%+ stock.

Under oath, I (we) state that the above and foregoing statements are true and correct. Please enter your full name as an electronic signature.