Beverage Permit Application

County, Tennessee — Complete all 21 questions below. Fields marked with * are required.

Before You Apply — Requirements Checklist

Applicants applying for a Beverage Permit in Anderson County must meet all of the following requirements:

✓Applicant must be at least 21 years of age
✓Applicant must obtain a business license
✓A background check is required upon applying for the Beverage Permit
✓A fee of $250.00, which is non-refundable, must be paid with the application
✓The applicant must provide a picture of the establishment
✓Plat map with footage on statement, and one notarized copy of the application
✓Fingerprints are required by the Beverage Board and done by a TBI contractor — the cost of fingerprints is paid by the applicant
✓Applicant must attend the Beverage Board meeting
✓Fingerprints must be turned into the County Clerk office at least 20 days prior to the Beverage Board meeting
✓The Beverage Board meets on the second tuesday of each month
✓The establishment must be 810 feet from a church, school, or public gathering place
✓A $100.00 Privilege Tax must be paid January 1 of each year

The applicant must meet all requirements of the Beverage Board; the County Clerk office is not responsible for any delays or applicant error.

Type of Permit Requested

I hereby make application for a permit to sell, store, manufacture, or distribute beer or other alcoholic beverages authorized to be sold, stored, manufactured or distributed under the provisions of Tennessee Code Annotated § 57-5-103 through 57-5-109 and I base my application upon the answers to the following questions:

Select the permit type*

Applicant Information (Questions 1-4)

1. Full name of applicant (owner of business)*

2. List all former names used including aliases, nicknames and maiden name

3. Type of applicant*

4. Give the name, address and birth date of all persons, corporations, joint-stock, syndicates or associates who own 5% or more of the business (attach additional sheet if needed)

Address & Contact Information (Questions 5-8)

5. What is your present address?*

6. List all previous addresses within the last ten years (use additional sheet if necessary)

7. Applicant's Date of Birth*

8a. Applicant's Home Telephone Number

8b. Applicant's Landline Business Telephone Number

Business Information (Questions 9-13)

9. Under what name will this business operate?*

10. Give business address and geographical location*

11. Describe the nature or type of the business you will operate

12. Name and address of person to receive annual tax notices and other official communications or legal correspondence

Name

Address

13. Name and address of property owner (if other than business owners)

Premises & Management (Questions 14-15)

14. Will this permit be used to operate two or more restaurants or other businesses within the same building?

YesNo

15. Give the name, date of birth and address of any manager other than the applicant:

Manager name

Manager date of birth

Manager address

Legal History (Questions 16-18)

16. Has any person who owns five percent (5%) or more of the business, any manager listed above, or any other employee of the business, been convicted of any violation of the beer or alcoholic beverage laws, felony crime or any misdemeanor crime or any misdemeanor crime involving moral turpitude (defined as crimes involving theft, fraud or false statements) within the past ten (10) years?

IMPORTANT: If you have any doubt regarding whether or not a past criminal convicted qualifies as a misdemeanor/felony or crime involving moral turpitude, you should consult with an attorney prior to completing this application.

YesNo

17. Have you, your business, or any person who owns five percent (5%) or more of the business, ever had a beverage permit previously issued, revoked, suspended or denied in the State of Tennessee?

YesNo

18. Give the name, relationship to the applicant and address of the former beverage permit holder at this location (if applicable)

Nearby Establishments (Questions 19-21)

19. Give the name and address of the school nearest your business

20. Give the name and address of the church or other place of worship nearest to your business

21. Give the name of the owner and the address of the residential dwelling closest to your business

Supporting Documents

Upload any supporting documents with your application. You may also bring physical copies to the County Clerk's office.

Accepted formats: PDF, JPG, PNG, DOC, DOCX, TXT. Maximum file size: 30MB.

No document categories configured for this county.

Declarations & Certification

I have read and fully understand the terms and conditions set forth in the application. I understand this application is part of the Beverage Permit and further understand the normal procedure for processing this application is a background check. I certify that all information is true and authorize a Tennessee Bureau of Investigation to make the necessary investigation and to release any and all information to the County Beverage Board.

I understand the County has adopted a rule forbidding the sale, storage, or manufacture of beer within 810 feet of a church, school, or other place of public gathering.

I, further, understand the County has adopted a rule forbidding the sale, storage, manufacture of beer or like beverages within 300 feet of a residential dwelling, if the owner objects to the issuance of a beverage permit.

I understand that I must provide documentation to the County that I have registered with the State Commissioner of Revenue for sales tax purposes within ten (10) days following issuance of a beverage permit. I also understand that failure to provide this information will result in revocation of the permit.

I certify this application contains true information to the best of my knowledge and belief. I am aware of my continuing obligation to amend or supplement this application promptly if a change in circumstances affects the responses provided in this application, either before or after a permit has been issued, including, but not limited to, information regarding myself, other owner, employees or the addition of new employees. I certify that I am knowledgeable of the laws prohibiting the sale of beer to minors. I am aware that I will not be issued a beverage permit or my permit will be revoked if my business location causes traffic congestion of interferes with schools, churches, or other places of public gathering or otherwise interferes with the public health, safety and morals. I will surrender to the Beverage Board any permit issued under this application within fifteen (15) days of termination of the business, change in ownership, relocation of the business, or change of the business's name.

NOTICE: A non-refundable $250.00 fee must accompany this application. If the application is approved, you are required to provide documentation of sales tax registration to the county within ten (10) days of approval.

An annual privilege tax of $100.00 is imposed on the business of selling, distributing, storing or manufacturing beer in this state. The tax is due each January 1 and is payable to the County County Clerk. This tax is prorated for new permits issued after January 1 and must be paid when the permit is issued.

WARNING: ANY APPLICANT MAKING A FALSE STATEMENT IN THIS APPLICATION SHALL FORFEIT HIS OR HER PERMIT AND SHALL NOT BE ELIGIBLE TO RECEIVE A PERMIT FOR TEN (10) YEARS.

Email address (for status lookup and correspondence)*

Send me email updates when my application status changes, a requirement is completed, or my application is approved/rejected.I certify that this application contains true, complete, and correct information to the best of my knowledge and belief. I understand that any false statements may result in denial of the permit and a 10-year prohibition from holding a beverage permit. *

By submitting, you agree to the terms and declarations above.