Form Abc 807 – Fill Out and Use This PDF

The ABC 807 form serves as a vital document for those engaged in providing management or operational services to retail liquor licensees in Kansas. It is a comprehensive form issued by the Kansas Department of Revenue's Alcoholic Beverage Control Division, requiring detailed information regarding the licensee and the entity offering managerial services, including the disclosure of all owners, officers, shareholders, and others who will perform these services. To streamline compliance and ensure all required details are accurately captured, fill out the ABC 807 form by clicking the button below.

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Form Abc 807 PDF Details

The ABC 807 form is a critical document required by the Kansas Department of Revenue’s Alcoholic Beverage Control Division, ensuring transparency and legal compliance in the management of retail liquor licenses. Based in Topeka, Kansas, this form serves multiple purposes. Firstly, it gathers essential licensee information, including the entity's legal name, its doing-business-as (DBA) name, license number, and the physical address of the licensed establishment. The form also delves into the specifics of the management services provided, requiring details about the person or entity responsible for these services, alongside a comprehensive disclosure of all owners, officers, shareholders, stockholders, copartners, and/or trustees involved. It’s important because it ensures those offering management services to liquor retailers disclose their ownership stakes, personal information, and background qualifications comprehensively. The form doesn’t shy from probing into the backgrounds of the individuals listed, asking pointed questions about criminal convictions, involvement in other licensed alcohol or beverage establishments, and meeting Kansas’ residency requirements for holding a liquor license. Furthermore, a section dedicated to tax clearance verifies the applicant’s good standing with the state’s tax obligations. This detailed procedural step ensures that all involved parties are vetted meticulously, supporting responsible alcohol management and sales practices in Kansas. By submitting this form, the signatories affirm under penalty of perjury that all provided information is true, accurate, and complete, reinforcing the accountability and regulation standards upheld by the state's liquor control authorities.

Question	Answer
Form Name	Form Abc 807
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	abc807 kansas dept of revenue abc 807 form

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	Kansas Department of Revenue
	Alcoholic Beverage Control Division
	915 S.W. Harrison Street, Room 214
	Topeka, KS 66625-3512
	Phone: 785-296-7015		Fax: 866-855-5025
	MANAGEMENT SERVICES INFORMATION


SECTION 1 – LICENSEE INFORMATION				FEIN______________________
Licensee DBA Name				License Number

Location Street Address		City		County	Zip Code


SECTION 2 – MANAGEMENT SERVICES INFORMATION
Name of Person/Entity Providing Management/Operational Services				FEIN

Contact Person				Daytime Phone

The following information must be provided on all owners, officers, shareholders, stockholders, copartners and/or trustees of the entity who will perform management services for the retail liquor licensee. (Attach additional pages as necessary). The percentages of ownership must total 100%.

SECTION 3 – MANAGEMENT SERVICES OWNERSHIP INFORMATION

Last Name		First Name	Middle Name			Gender	Date of Birth	Birthplace

Other Names Used				Maiden Name

Social Security No.	Driver’s License No.		State		% Ownership		Position	Marital Status

Address	City		State		County		Zip Code	Daytime Phone



Last Name		First Name	Middle Name			Gender	Date of Birth	Birthplace

Other Names Used				Maiden Name

Social Security No.	Driver’s License No.		State		% Ownership		Position	Marital Status

Address	City		State		County		Zip Code	Daytime Phone




Last Name		First Name	Middle Name			Gender	Date of Birth	Birthplace

Other Names Used				Maiden Name

Social Security No.	Driver’s License No.		State		% Ownership		Position	Marital Status

Address	City		State		County		Zip Code	Daytime Phone




Last Name		First Name	Middle Name			Gender	Date of Birth	Birthplace

Other Names Used				Maiden Name

Social Security No.	Driver’s License No.		State		% Ownership		Position	Marital Status

Address	City		State		County		Zip Code	Daytime Phone




Last Name		First Name	Middle Name			Gender	Date of Birth	Birthplace

Other Names Used				Maiden Name

Social Security No.	Driver’s License No.		State		% Ownership		Position	Marital Status

Address	City		State		County		Zip Code	Daytime Phone

ABC-807 (7.1.11)

Page 1 of 2

Kansas Department of Revenue

Alcoholic Beverage Control Division

915 S.W. Harrison Street, Room 214

Topeka, KS 66625-3512

Phone: 785-296-7015 Fax: 866-855-5025

FEIN_____________________

SECTION 4 – BACKGROUND QUALIFICATIONS

If the answer to any question is yes, provide explanation on separate page and attach to the form.

1.	Has any person listed in Section 3 been convicted of a felony in Kansas, in any other state, or under federal	Yes	No
	law?	Yes	No
	law?
2.	Has any person listed in Section 3 been convicted of a morals charge (prostitution; procuring any person;
	solicitation of a child under 18 for immoral act involving sex; possession or sale of narcotics, marijuana,	Yes	No
	amphetamines or barbiturates; rape; incest; gambling; adultery; or bigamy) in Kansas or any other state?
3.	Has any person listed in Section 3 had an alcoholic liquor or cereal malt beverage license revoked in Kansas	Yes	No
	or in any state?	Yes	No
	or in any state?

4.	Is any person listed in Section 3 currently a law enforcement officer or non-elected official who supervises or	Yes	No
	appoints any law enforcement officer?	Yes	No
	appoints any law enforcement officer?
5.	Does any person listed in Section 3 have an ownership interest in any other business licensed to sell
	alcoholic liquor or cereal malt beverage in Kansas or any other state? If so, please provide license number.	Yes	No
	and state of issue. License Number: ________________________________ State: __________________
6.	Does any person listed in Section 3 not meet the Kansas residency requirement for the type of license
	applied for? (Class A & B Club, Drinking Establishment – 1 year; Farm Winery, Microbrewery or Retailer – 4	Yes	No
	years; Manufacturer – 5 years).
7.	Has any person listed in Section 3 been a Kansas resident for less than 10 years?	Yes	No

SECTION 5 – TAX CLEARANCE

Has the applicant obtained their Tax Clearance certificate?

*If yes, enter your Tax Clearance confirmation number:_______________________________________

**If no, you must request your Tax Clearance certificate.

To obtain your tax clearance, go to: http://www.ksrevenue.org/taxclearance.html

Yes*

No**

Under penalties of perjury, I declare the information contained in this document a true, accurate and complete disclosure of information.

Licensee Signature

Date

Management Services Signature

Date

ABC-807 (7.1.11)

Page 2 of 2

How to Edit Form Abc 807 Online for Free

Using PDF files online is certainly quite easy with our PDF tool. Anyone can fill in Form Abc 807 here painlessly. In order to make our editor better and less complicated to use, we consistently develop new features, bearing in mind feedback coming from our users. This is what you will want to do to begin:

Step 1: First of all, access the pdf editor by pressing the "Get Form Button" above on this webpage.

Step 2: Once you access the online editor, you will find the document all set to be filled out. Apart from filling in different fields, it's also possible to perform some other actions with the file, including adding custom words, editing the initial textual content, inserting images, signing the PDF, and a lot more.

Filling out this PDF calls for care for details. Ensure that every single blank is filled out correctly.

1. It's essential to complete the Form Abc 807 accurately, therefore be attentive while filling in the sections comprising these specific fields:

Form Abc 807 writing process explained (portion 1)

2. Once your current task is complete, take the next step – fill out all of these fields - Middle Name, Other Names Used, Maiden Name, Social Security No, Drivers License No, Address, City, State, State, Ownership, Position, Marital Status, County, Zip Code, and Daytime Phone with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

3. In this particular part, take a look at Address, City, State, County, Zip Code, Daytime Phone, ABC, and Page of. Each of these will have to be completed with utmost precision.

Form Abc 807 completion process outlined (stage 3)

4. The fourth section arrives with the following form blanks to look at: FEIN, SECTION BACKGROUND, Is any person listed in Section, Has any person listed in Section, Yes No, Yes No, Yes No, Yes No, Yes No, Yes No, Yes No, SECTION TAX CLEARANCE Has the, and Yes No.

Always be extremely attentive while filling in Yes No and Is any person listed in Section, because this is where a lot of people make some mistakes.

5. To finish your document, this last subsection requires a few additional blanks. Filling out Under penalties of perjury I, Licensee Signature Date, Management Services Signature Date, ABC, and Page of is going to conclude everything and you can be done in the blink of an eye!

Form Abc 807 completion process explained (part 5)

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Form Abc 807 – Fill Out and Use This PDF

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