Form E-141 A at a glance
What it is: Form E-141 A is the ABC Employee List.
Where and when to file: This form must be fully completed, kept on the licensed premises and available at any time for inspection by the NJABC or any law enforcement officer.
A filled-in Form E-141 A example: a tavern lists two employees
How to fill out Form E-141 A, box by box
Name of licensee and ABC license number
Enter the Name of Licensee, Doing Business As or Trading As, and the ABC License Number.
Name and street address
Enter the Name and the Street Address: the Actual Residence While Employed Here, Street, City, State and Zip Code.
Age, date of birth and place of birth
Enter the Age and the Date of Birth, and the Place of Birth: City and State if not born in U.S.A., City, Province and Country.
U.S. citizen and employment dates
Under U.S. Citizen YES/NO, enter Yes or No; then enter the Date Employment Started and the Date Employment Ended.
Job title and alcoholic beverages
Enter the Actual Job Title the employee is Employed As and enter Yes or No: Do you sell, serve or deliver alcoholic beverages?
Convicted of a crime
Enter Yes or No: Ever been convicted of a crime? (1st through 4th degree)
ABC Rehab permit number
Enter Yes or No: Is an ABC Rehab Permit or Disqual Removal required? If required, enter the ABC Rehab / Disqual Employment Permit Number.
*** For Class C Retail Licensees only - No ABC Rehab Permit or Disqual Removal is required if the employee is going to perform duties that do not involve serving, selling or soliciting the sale of any alcoholic beverage; participating in the mixing, processing or preparation of alcoholic beverages; providing security or admission-monitoring services for the premises; or providing or participating in any management or professional services. HOWEVER, if the conviction was for a sex offense as set forth in NJSA 2C:7-2 (Megan's Law) or a crime involving moral turpitude committed while on a licensed premises, an ABC Permit is still required.
Sources
[1] Form E-141 A, ABC Employee List, New Jersey Division of Alcoholic Beverage Control (the Official source link on this page).