Fillable ABCC - Retail License Change Of Manager

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ABCC - Retail License Change Of Manager

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The ABCC - Retail License Change Of Manager form is 6 pages long and contains:

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  • 23 check-boxes
  • 95 other fields

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File type: PDF

U.S.A. forms for Commonwealth of Massachusetts

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Below you will find a step-by-step explanation of the change of manager amendment application process. Please read this entire
page before you apply for an amendment to your license as it provides critical information on the approval process.
The ABCC urges you to reach out to the Local Licensing Authority (“LLA”) in the city or town in which you are applying for a
change of manager amendment to your license before applying. While state law requires you to submit certain documents, your
LLA may have other documents and/or fees required of you before it will consider your application, and failure to contact them
before you apply for a change of manager amendment to your license may delay the consideration of your application.
The granting of a retail license amendment involves a three-step process under M.G.L. c. 138, §§ 15A & 16B:
1. Step One is the granting of an amendment application by the LLA;
2. Step Two is approval by the ABCC;
3. Step Three is the issuance of the amended retail license by the LLA.
Each step has certain legal requirements:
Step One. In Step One, when you submit your application with the LLA, the LLA is required by law to note the date and hour
your application is filed with it. The LLA must act on an application within 30 days of it being filed.
If the LLA grants the license, the application shall be forwarded to the ABCC no later than 3 days following such approval.
Step Two. In Step Two, when the ABCC receives an amendment application that has been approved by the LLA, an investigator
will be assigned. The investigator will investigate the proposed manager, examining any criminal background and fitness of
character. Parties to an amendment application must respond promptly to investigators’ inquiries. Failure to do so will result in
a delay of the approval and may result in a denial of the amendment application.
Step Three. Once the LLA receives the ABCC’s approval of an amendment application, it must issue the amended license within
7 days.
The Commonwealth of Massachusetts
Alcoholic Beverages Control Commission
239 Causeway Street
Boston, MA 02114
www.mass.gov/abcc
AMENDMENT APPLICATION FOR A CHANGE OF MANAGER
Change of Manager Amendment Application (this packet)
CORI Authorization Form
Vote of the Corporate Board
For the manager of record AND any individual with direct or indirect interest in the
proposed licensee. This form must be notarized with a stamp*
A corporate vote appointing the manager of record, signed by an authorized signatory for the
proposed licensed entity
Monetary Transmittal Form with $200 fee
The Commonwealth of Massachusetts
Alcoholic Beverages Control Commission
239 Causeway Street
Boston, MA 02114
www.mass.gov/abcc
AMENDMENT APPLICATION FOR A CHANGE OF MANAGER
The following documentation is required as a part of your retail license application.
ABCC investigators reserve the right to request additional documents as a part of their investigation.
Additional Documents Required by the Local Licensing Authority
Proof of Citizenship for proposed manager of record
Passport, US Birth Certificate, Naturalization Papers, Voter Registration
You can PAY ONLINE or include a $200 check made out to the ABCC
The Commonwealth of Massachusetts
Alcoholic Beverages Control Commission
239 Causeway Street
Boston, MA 02114
www.mass.gov/abcc
AMENDEMENT APPLICATION FOR A CHANGE OF MANAGER
Please complete this entire application, leaving no fields blank. If field does not apply to your situation, please write N/A.
First Name: Last Name:Middle:
Title: Primary Phone:
Email:
2. APPLICATION CONTACT
The application contact is required and is the person who will be contacted with any questions regarding this application.
1. NAME OF LICENSEE (Business Contact)
1
ABCC License Number City/Town of Licensee
Entity Name:
Primary Phone:
3. BUSINESS CONTACT
Please complete this section ONLY if there are changes to the Licensee phone number, business address (corporate
headquarters), or mailing address.
Alternative Phone: Email:
Fax Number:
Business Address (Corporate Headquarters)
Street Name:
Street Name:
State:
Zip Code:
City/Town:
Country:
Zip Code:
City/Town: State:
Street Number:
Country:
Mailing Address
Check here if your Mailing Address is the same as your Business Address
Street Number:
4. MANAGER CONTACT
Salutation First Name Middle Name Last Name Suffix
Primary Phone:
Alternative Phone:
Email:
Date of Birth
Mobile Phone:
Fax Number
Place of Employment
Have you ever been convicted of a state,
federal, or military crime?
Have you ever been Manager of Record of a
license to sell alcoholic beverages?
Are you a U.S. Citizen?
Social Security Number
APPLICATION FOR A NEW RETAIL ALCOHOLIC BEVERAGES LICENSE
If yes, percentage of interest
Do you have direct, indirect, or
financial interest in this license?
Date(s) Position Employer Address Phone
Employment Information of Proposed Manager
Please provide your employment history for the past 10 years
If yes, please indicate type of Interest (check all that apply):
Officer
Stockholder
LLC Member
Partner
Contractual
Management Agreement
Sole Proprietor
LLC Manager
Director
Landlord
Revenue Sharing
Other
Prior Disciplinary Action of Proposed Manager
Have you ever been involved directly or indirectly in an alcoholic beverages license that was subject to disciplinary action? If
yes, please complete the following:
Date of Action Name of License State City Reason for suspension, revocation or cancellation
Yes No
Yes No
Yes No
Yes No
The Manager Contact is required and is the individual who will have day-to-day, operational control over the liquor license.
Citizenship / Residency / Background Information of Proposed Manager
Please indicate how many hours per week you intend to be on the licensed premises
If yes, please list the licenses
for which you are the current
or proposed manager:
If yes, attach an affidavit that lists your convictions with an explanation for each
2
PROPOSED MANAGER MUST COMPLETE A CORI REQUEST FORM
The following space is for any additional information you wish to supply or to clarify an answer you supplied in the application.
If referrencing the application, please be sure to include the number of the question to which you are referring.
ADDITIONAL SPACE
APPLICANT'S STATEMENT
I, the: sole proprietor; partner; corporate principal; LLC/LLP member
Authorized Signatory
of , hereby submit this application for
Name of the Entity/Corporation Transaction(s) you are applying for
(hereinafter the “Application”), to the local licensing authority (the “LLA”) and the Alcoholic Beverages Control Commission (the
“ABCC” and together with the LLA collectively the “Licensing Authorities”) for approval.
I do hereby declare under the pains and penalties of perjury that I have personal knowledge of the information submitted in the
Application, and as such affirm that all statement and representations therein are true to the best of my knowledge and belief.
I further submit the following to be true and accurate:
(1) I understand that each representation in this Application is material to the Licensing Authorities' decision on the
Application and that the Licensing Authorities will rely on each and every answer in the Application and accompanying
documents in reaching its decision;
(2) I state that the location and description of the proposed licensed premises does not violate any requirement of the
ABCC or other state law or local ordinances;
(3) I understand that while the Application is pending, I must notify the Licensing Authorities of any change in the
information submitted therein. I understand that failure to give such notice to the Licensing Authorities may result in
disapproval of the Application;
(4) I understand that upon approval of the Application, I must notify the Licensing Authorities of any change in the
Application information as approved by the Licensing Authorities. I understand that failure to give such notice to the
Licensing Authorities may result in sanctions including revocation of any license for which this Application is submitted;
(5) I understand that the licensee will be bound by the statements and representations made in the Application, including,
but not limited to the identity of persons with an ownership or financial interest in the license;
(6) I understand that all statements and representations made become conditions of the license;
(7) I understand that any physical alterations to or changes to the size of, the area used for the sale, delivery, storage, or
consumption of alcoholic beverages, must be reported to the Licensing Authorities and may require the prior approval
of the Licensing Authorities;
(8) I understand that the licensee's failure to operate the licensed premises in accordance with the statements and
representations made in the Application may result in sanctions, including the revocation of any license for which the
Application was submitted; and
(9) I understand that any false statement or misrepresentation will constitute cause for disapproval of the Application or
sanctions including revocation of any license for which this Application is submitted.
Signature: Date:
Title:
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ABCC - Retail License Change Of Manager

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Completed 17 May 2020

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