There are a few things to keep in mind when filing Form AB 0009. The most important is to make sure that all of the information is correct and accurate. This form is used to report the amount of tax that has been withheld from employee paychecks, so it's important to ensure that the information is correct. Another thing to keep in mind is that this form needs to be filed by each employer who withholds taxes from their employees' paychecks. Finally, make sure you have all the necessary documentation handy when filling out this form. If you have any questions, be sure to speak with an accountant or tax professional for assistance.
| Question | Answer |
|---|---|
| Form Name | Form Ab 0009 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | ABC QUESTIONNAIRE 6 4 2010 state of tennessee alcoholic beverage commission questionnaire form |
Address:
226 Capitol Blvd. Suite 300 Nashville, TN
4420 Whittle Springs Road Knoxville, TN 37917
170North Main, 11th Floor Memphis, TN
540 McCallie Ave, Suite 341 Chattanooga, TN 37402- 2055
ALL questions MUST be answered even if answered N/A.
ALL signatures spaces MUST be signed and notarized.
www.tn.gov/abc
STATE OF TENNESSEE
ALCOHOLIC BEVERAGE COMMISSION
QUESTIONNAIRE
Each person having ownership interests and/or managerial duties and are making an application for a permit to sell alcoholic beverages, must complete and submit a questionnaire, which is to be attached to the application for the permit.
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Name of Applicant |
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Address of Applicant |
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Name of Establishment |
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Job Tile and/or Office Held |
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Are you applying for an
1.Is the business to be operated as a corporation, a general or limited partnership, or are you the sole owner?
2.State amount of capital you propose to invest in the business $
3.From whom were these funds obtained (state in detail)?
4.If savings or personal funds, give name of bank where deposited
5.If a loan was made for this investment, state from whom made and the amount
6.State names and addresses and type of business where employed for the past five years.
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7.If you were self employed state when and where and type of business
8.Have you purchased and/or currently applied for a U.S. Department of Treasury Special Tax Registration ― (Alcohol and Tobacco) stamp in your name permitting you to engage in a business of selling or dispensing alcohol?
If answer is yes, provide specifics (names).
9.If applicant is purchasing the stock and fixtures of a licensee now engaged in business, state the amount of the purchase price and the terms agreed upon, also attach a copy of the Bill of Sale
10.Provide the name and address of any relative employed by the Tennessee Alcoholic Beverage Commission
(CONTINUED ON BACK)
FORM
11.Do you or any person having any interest in this business, directly or indirectly, either proprietary or by means of any loan, mortgage or lien, or participation in the profits in any way, hold a public office, either representative or elective, National, State, City or County? _______. If so, what office?
12.Are you indebted to the State of Tennessee for any taxes? If yes, state the tax and amount
13.Give the name and address of any relative that has any interest in any liquor business
14.Have you or has any person to be employed by you in the sale or dispensing of alcoholic or malt beverages ever been convicted of any violation of any law against possession, sale, manufacture, or transportation of intoxicating liquor, or any crime involving moral turpitude?
If answer is yes, furnish complete details including DATE, PLACE, CHARGE and DISPOSITION.
15.Have you or any person to be employed by you in the sale or dispensing of alcoholic or malt beverages ever been
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convicted of any criminal offense? |
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answer is yes, furnish complete details including DATE, |
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PLACE, CHARGE, and DISPOSITION. |
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16. Are you a citizen of the United States: |
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No |
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If naturalized, set forth DATE, PLACE and COURT.
17. Give the names and addresses of three references
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18. Give the name and address of one bank reference.
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19. Furnish full name, nickname or any other names by which you are or have been known.
20. State Age: __________ Date of Birth: __________________ Place of Birth:
Social Security # _________________________________Driver’s License #
Sex: _____________________________ Race:
Signature of Applicant
Signature of Owner of Establishment
Subscribed and sworn to before me this ___________day of ____________________20
My Commission Expires ____________________
Notary Public
*The State of Tennessee and the Tennessee Alcoholic Beverage Commission are an Equal Opportunity Employer. Discrimination, in any of its practices, which is based on age, race, sex, color, religion, national origin, disabling condition or any other nonmerit factor is prohibited. Thus, the Tennessee Alcoholic Beverage Commission is an equal opportunity, equal access, affirmative action public entity.
FOR ADDITIONAL INFORMATION:
Contact the agency ADA Coordinator for this state agency: Assistant Director at