HomeMy WebLinkAboutForm - Application for Temporary License (fillable)DEPARTMENT OF LIQUOR CONTROL COUNTY OF HAWAI‘I
Hilo Lagoon Centre, 101 Aupuni St., Unit 230, Hilo, Hawai‘i 96720 * Phone: (808)961-8218 * Fax: (808)961-8684
E-Mail: cohdlc@co.hawaii.hi.us
APPLICATION FOR TEMPORARY LICENSE
Pursuant to Rule 4-3, Rules and Regulations of the Liquor Commission of the County of
Hawai‘i, application is hereby made for a temporary license to be effective _________________ or as ordered by the Liquor Commission or Director.
Applicant:
Trade Name:
By
(Signature)
Name:
Title:
Date:
Phone No.:
E-Mail:
The following conditions apply to a temporary license:
1. The term of a temporary license shall be for 120 days, $50.00 fee. 2. An additional term of 120 days is permitted upon application and payment of $50.00 fee.
3. The applicant shall appoint valid liquor card holders pursuant to Rule 5-2.
4. Payment for liquor purchases from manufacturers or wholesale dealer licensees shall be
in currency or certified check, except as authorized by Rule 4-3-F.
Fee: $
Ck. No.:
Hawai‘i County is an Equal Opportunity Provider and Employer