Alcohol License Application

Alcohol License Application

Orem Business License Department | 56 N Center Street Floor 2 | Orem, UT, 84057 | 801-229-7198
- Official Use Only
- License #
- Payment Date
  
  MonthDayYear
  Date
- Required submittal of $
- And the items listed below as application for a
- CLASS __ Alcohol License
- Required Documentation Checklist (Attach to this form):
  - City of Orem Business License
  - Floor plan of business premises outlining where alcoholic beverages are kept, stored, and sold
  - Proof of Commercial General Liability Insurance
  - State of Utah, B.C.I. Background Check
  - Copy of temporary State Issued Alcohol License (Class B&E Only)
  - Cash or Surety Bond for $1,000 (Class D Only)
- File Upload
  
  Cancelof
- Business Information
- Business Name
- Federal Tax ID# (EIN)
- Business Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Business Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Mailing Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Locations of other alcohol/beer licenses held:
- Owner Information
- Business Owner Name
  
  First NameLast Name
- Previous Owner Name, if applicable
  
  First NameLast Name
- Date of Birth
  
  MonthDayYear
  Date
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Owner Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Manager Information
- Business Manager Name
  
  First NameLast Name
- Previous Manager Name, if applicable
  
  First NameLast Name
- Date
  
  MonthDayYear
  Date
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Manager Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Alcohol License Fee Schedule
- If a license is issued for less than a full year, the fee is pro-rated and reduced by 25% for each full quarter, calculated from July 1st, with the exception of the Local Consent Fee. License are non-transferable and will expire upon change of ownership.
- Only one signature is required if the applicant is a partnership, association, corporation, franchisee, or other business entity. However, complete information on all officers, managers, partners, directors, members, or owners must be provided.
- I, the undersigned, understand and agree to comply with all regulations of Chapter 3 of the Orem City Code, Alcoholic Beverages. I hereby hold harmless the City of Orem, Department of Public Safety, and all others from liability or damage which may result from furnishing the information requested. I hereby grant any authorized representative of the City of Orem or law enforcement officer the unrestricted right to enter the licensed premises during business hours.
  
  I certify that I have never been convicted of a felony. I certify that I have never been convicted of any violation or any law or ordinance relating to alcholic beverages, or any crime involving moral turpitude, and that I have never had any license or permit involving alcoholic beverages revoked within the last three years.
  
  I also certify that I have complied with the requirements, and posess the qualifications specified in the Alcoholic Beverage Control Act of Utah, and that all the information I have provided in the application is true. I agree that if a license is issues, it shall be subject to suspension or revocation as provided in Chapter 3 of the Orem City Code.
- Signature
  
  Clear
- Date
  
  MonthDayYear
  Date
- Printed Name
  
  First NameLast Name
- Title
- ID Check by
  
  Clear
Should be Empty:

Alcohol License Application

Official Use Only

Business Information

Owner Information

Manager Information