Form Abc 217 – Fill Out and Use This PDF

The ABC 217 form serves as an Application Questionnaire for entities and individuals seeking to obtain or transfer a license related to the sale of alcoholic beverages in the State of California. It requires detailed information about the applicant, the type of license sought, and financial details to ensure compliance with the Department of Alcoholic Beverage Control regulations. To expedite the process of participating in California's alcohol marketplace, take the first step by completing the form accurately and comprehensively.

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Form Abc 217 PDF Details

The ABC-217 form, issued by the Department of Alcoholic Beverage Control, serves as a comprehensive application questionnaire for individuals or entities seeking alcoholic beverage licensing in the State of California. This intricate document, under the governance of Gavin Newsom, outlines a meticulous process for applicants to disclose key information about themselves, the type of license they are applying for, and detailed aspects of the transaction involved. It encompasses a variety of license and transaction types, including but not limited to off-sale beer and wine, on-sale general eating places, and premises-to-premises transfers. Applicants are required to provide information regarding the premises where the license will be issued, including its address, whether it's within city limits, and its operational status. Furthermore, the form delves into financial information, asking for details on investment sources and costs associated with securing the license. This includes initial investment breakdowns, escrow and accounting details, and disclosure of funding sources. The ABC-217 form also mandates transparency regarding any previous convictions or violations related to the Alcoholic Beverage Control Act, emphasizing the importance of integrity in the licensing process. By signing the ABC-217, applicants grant the Department of Alcoholic Beverage Control extensive access to review and verify their financial and business records, underpinning the rigorous scrutiny applied to ensure compliance and suitability for holding an alcoholic beverage license in California.

Question	Answer
Form Name	Form Abc 217
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	abc form 217, form abc 217, application questionnaire form, abc application form

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Department of Alcoholic Beverage Control

APPLICATION QUESTIONNAIRE

Please read instructions, which includes Privacy Notice, before completing form.

State of California Gavin Newsom, Governor

1. APPLICANT'S NAME(S) (If an individual, first name, middle name, last name. Name of entity if corporation, limited partnership or limited liability company.)

P-12 LICENSEE

Yes

(If yes, complete form ABC-811)

LICENSE TYPE(S) (Check appropriate items)

3. TRANSACTION TYPE (Check appropriate item)

Off-Sale Beer & Wine

Original (New)

Off-Sale General

Person-to-Person Transfer (check appropriate section):

On-Sale Beer

Section 24071 (Surviving spouse, corporations, fiduciaries, etc.)

On-Sale Beer & Wine Eating Place

Section 24071.1 (Corporate Stock/Limited Partnership)

On-Sale Beer & Wine Public Premises

Section 24071.2 (Limited Liability Company)

On-Sale General Eating Place

Premises-to-Premises Transfer

On-Sale General Public Premises

Exchange

Other

TEMPORARY PERMIT REQUESTED (Person-to-Person transfers only)

Yes

PREMISES ADDRESS (Where license to be issued) (Street number and name, city, zip code)

County

PREMISES TELEPHONE NUMBER

7. PREMISES ARE INSIDE CITY LIMITS

8. BUSINESS NAME (DBA) YOU WILL USE

Yes

BUSINESS MAILING ADDRESS (Street number and name, city, state, zip code)

10. MAILING ADDRESS

Permanent

Temporary

11. ABC LICENSE COST (Item #33a on reverse)

12. SUBTOTAL (Item #33f on reverse)

13. HAS THE APPLICANT(S) EVER BEEN

14. HAS THE APPLICANT(S) EVER VIOLATED ANY OF THE PROVISIONS OF THE ALCOHOLIC BEVERAGE CONTROL ACT OR REGULATIONS

CONVICTED OF A FELONY?

OF THE DEPARTMENT PERTAINING TO THE ACT?

Yes

15. IF YES TO ITEM 13 OR 14, PLEASE EXPLAIN

16. TRANSFEROR'S NAME (If an individual, last, first, middle. Name of entity if corporation, limited partnership or limited liability company.)

17. ABC LICENSE NUMBER

18.

TRANSFEROR'S PREMISES ADDRESS (Where license is now issued) (Street number and name, city, zip code)

19.

PREMISES UNDER CONSTRUCTION

IF YES, LIST ESTIMATED COMPLETION DATE

20. FRANCHISE

Yes

21.

NAME OF PERSON WE MAY CONTACT (For the applicant)

22.

TITLE OF CONTACT PERSON

23.

CONTACT TELEPHONE NUMBER

24.

CONTACT E-MAIL ADDRESS

25.

PREMISES IS CURRENTLY LICENSED

IF YES, TYPE OF LICENSE

26.

CURRENT LICENSE IS OPERATING

IF NO, DATE CLOSED

Yes

FINANCIAL INFORMATION

27.

ESCROW COMPANY'S NAME

ESCROW COMPANY'S ADDRESS

TELEPHONE NUMBER

28.

BOOKKEEPER/ACCOUNTANT'S NAME

BOOKKEEPER/ACCOUNTANT'S ADDRESS

TELEPHONE NUMBER

29.

LANDLORD'S NAME

LANDLORD'S ADDRESS

TELEPHONE NUMBER

30.

MONTHLY RENT

31. LEASE EXPIRATION DATE

32. INDICATE WHETHER LEASE OR RENTAL AGREEMENT INCLUDES FURNITURE OR FIXTURES

All

Some

None

ABC-217 (rev. 01/19)

33. INVESTMENT INFORMATION		COST

a. ABC License		$
b. Furniture/fixtures		$
c. Inventory		$
d. Goodwill/non-compete
covenant		$

e. Leasehold and/or Improvements		$
f. SUBTOTAL (Usually should equal the recorded notice)		$
g. Fees for other licenses, permits, and deposits (approximate). Include Federal, State,
County or City license fees or permits; lease and utility deposits		$
h. Working capital (approximate)		$
i. Realty or interest therein		$
j. TOTAL INVESTMENT (Items f through i) (will equal total of amounts listed in item #33)		$

34. Source of Funds for Total Investment (item #33j) - identify amount(s), type(s) and explain source(s) and/or terms of Repayment

Amount	Type	Source and/or Terms of Repayment
$1,000	Gift	John Doe, Brother
$15,000	Promissory Note	to seller, payable @ $1,000 per month for 15 months
$10,000	Loan	from ABC Bank, @ 8.5% over 5 yrs; monthly payment = $2,052

35. LIST ALL BANK ACCOUNTS FOR THIS BUSINESS OPERATION

BANK NAME

BANK ADDRESS

ACCOUNT NUMBER

c. NAMES OF ALL PERSONS AUTHORIZED TO SIGN ON BANK ACCOUNT(S) (Print)

I understand that falsification of the information on this form may constitute grounds for denial or revocation of the license(s). For a period of 90 days from this date, I/we hereby authorize the Department of Alcoholic Beverage Control, or any of its officers, to examine and secure copies of financial records consisting of signature cards, checking and savings accounts, notes and loan documents, deposit and withdrawal records, and escrow documents of my/our financial institution(s) or any financial records established in connection with this business. This authorization to examine records at any financial institution may be revoked at any time. I/we also authorize the Department of Alcoholic Beverage Control, or any of its officers, to examine and secure copies of any business records or documents established in connection with this business including, but not limited to those on file with my/our bookkeeper. I/we also read all of the above and declare under penalty of perjury that each and every statement is true and correct.

36. APPLICANT SIGNATURE (Only one signature needed)

PRINTED NAME

DATE SIGNED

ATTEST (ABC Employee or Notary Public)

ABC-217 (rev. 01/19)

How to Edit Form Abc 217 Online for Free

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Step 1: Open the form in our editor by clicking the "Get Form Button" above on this page.

Step 2: As soon as you start the tool, you will notice the form ready to be filled in. In addition to filling in various blank fields, you may also perform many other things with the file, namely adding custom text, editing the initial textual content, adding images, placing your signature to the form, and much more.

When it comes to blanks of this precise PDF, this is what you need to know:

1. To begin with, when filling in the abc form 217, beging with the area containing subsequent fields:

2. Once your current task is complete, take the next step – fill out all of these fields - TRANSFERORS NAME If an individual, ABC LICENSE NUMBER, TRANSFERORS PREMISES ADDRESS, PREMISES UNDER CONSTRUCTION, IF YES LIST ESTIMATED COMPLETION, Yes, NAME OF PERSON WE MAY CONTACT For, TITLE OF CONTACT PERSON, FRANCHISE, Yes, CONTACT TELEPHONE NUMBER, CONTACT EMAIL ADDRESS, PREMISES IS CURRENTLY LICENSED, IF YES TYPE OF LICENSE, and CURRENT LICENSE IS OPERATING with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

3. Throughout this part, check out MONTHLY RENT, LEASE EXPIRATION DATE, INDICATE WHETHER LEASE OR RENTAL, All, Some, None, and ABC rev. Every one of these should be filled in with highest precision.

Stage number 3 of filling out abc fill in

4. The subsequent paragraph comes with these blank fields to complete: INVESTMENT INFORMATION, a ABC License, b Furniturefixtures, Inventory, c d Goodwillnoncompete, covenant, e Leasehold andor Improvements, f SUBTOTAL Usually should equal, County or City license fees or, h Working capital approximate, i Realty or interest therein, COST, j TOTAL INVESTMENT Items f through, Amount, and Type.

Find out how to fill out abc fill in stage 4

It is possible to make an error while completing the i Realty or interest therein, hence be sure to go through it again before you finalize the form.

5. This form needs to be finished by filling in this section. Below there is a full list of form fields that need appropriate information in order for your document submission to be complete: LIST ALL BANK ACCOUNTS FOR THIS, BANK ADDRESS, ACCOUNT NUMBER, b c NAMES OF ALL PERSONS, I understand that falsification of, PRINTED NAME, and DATE SIGNED.

abc fill in completion process shown (step 5)

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Form Abc 217 – Fill Out and Use This PDF

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