HomeMy WebLinkAboutForm - Application for Solicitor's Permit (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 SOLICITOR’S PERMIT
Pursuant to Rule 3-2-D-4, of the Rules and Regulations of the Liquor Commission of the County of Hawaii,
application is hereby made for a Solicitor’s Permit for: Section I. To be completed by Applicant for a Solicitor’s Permit
Applicant: Date of Birth:
Business Address:
Telephone: Fax: E-mail:
Applicant requests permission to possess liquor for sampling to buyers: Yes No If yes: inventory will be stored at
Applicant: (Signature) Name: Date: Phone No.: E-Mail: Section II. To be completed by Manufacturer or Wholesale Dealer a valid holder of a liquor license for Name of Manufacturer or Wholesale Dealer Beer and Wine ($120) General ($180) Alcohol ($5)
in the County of Maui Kauai City and County of Honolulu, does hereby appoint
as our solicitor.
(Signature)
Name: Title: Date: Phone No.: PERMIT Your Application for a Solicitor’s Permit was approved on . The Commission: o Did not approve possession of liquor for the purpose of conducting samplings to liquor buyers.
o Approved possession of liquor for the purpose of conducting samplings to liquor buyers and inventory shall not exceed ___________ cases. By: Director Date: Ratified by the Liquor Commission on:
Expiration Date:
Attachments: Personal History Statement/Check Copy of Liquor License
Hawai’i County is an Equal Opportunity Provider and Employer