Fillable Alcoholic Beverage Off Premises Catering/Ancillary Tasting Event Notification (City of South Fulton)

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Alcoholic Beverage Off Premises Catering/Ancillary Tasting Event Notification (City of South Fulton)

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The Alcoholic Beverage Off Premises Catering/Ancillary Tasting Event Notification (City of South Fulton) form is 2 pages long and contains:

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  • 20 check-boxes
  • 30 other fields

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BROWSE CITY OF SOUTH FULTON (GA) FORMS

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Page 1 of 2 052020
Alcoholic Beverage Off Premises Catering/Ancillary Tasting
Event Notification Form
City of South Fulton Alcoholic Beverage License Information
Business Name
COSF Alcohol Beverage License #
Business Address with Suite/Unit
City
State
Zip Code
Licensee/Registered Agent Name
Licensee/Registered Agent Phone Number
Licensee/Registered Agent Email
Owner Name
Owner Phone Number
Owner Email
Type of Alcoholic Beverage License Held: (check all that apply)
Consumption on the Premises: Malt Beverages Wine Distilled Spirits
Retail Package Sale: Malt Beverages Wine Distilled Spirits
Quantity of Alcoholic Beverages to be Transported from Primary Location to Event:
Event Information
Name of Event:
Projected Attendance:
Location of (Address, Suite/Unit & Zip Code):
Dates of Event:
Beginning Time of Event*
Ending Time of Event*
Rules and Regulations
COSF resident caterers and businesses that hold either an Annual Alcohol Catering License or Ancillary
Beer and Wine Tasting License must utilize this form to inform the City and Police Department of any
events held in relation to use of said licenses.
Excise taxes must be paid and submitted to finance in the amounts set forth in the Alcoholic Beverage
Ordinance of the City of South Fulton.
Sunday sales. All off-premises events must comply with the requirements of state law with respect to the
service of alcoholic beverages on Sunday.
South Fulton Police Department
5539 Old National Highway
College Park, Georgia 30349
(470) 809-7372
Page 2 of 2 052020
The Following Must be Attached for Complete Submittal: (Check-Off)
A copy of COSF Off Premise Catering License (resident caterers only), or a copy of COSF Ancillary Beer
& Wine Tasting License.
A copy of any other required City special event approvals from the COSF Department of Community &
Regulatory Affairs.
AFFIDAVIT
Georgia, Fulton County
I, (print name) under oath, do hereby solemnly swear that (a) I
have read and understand the requirements set forth above and otherwise provided pursuant to Title 16 of the City of
South Fulton, Georgia, Alcoholic Beverage Ordinance, in order to procure this license/permit, and the licensee and/or
licensed premises presently meet all of the requirements to be eligible to obtain this license/permit. I further swear that
the information I have provided herein or otherwise to the City is true, and that I have made no knowingly false or
fraudulent statement to the City in order to procure the granting of this license/permit. In making the foregoing
representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent
statement or representation in this affidavit shall be guilty of a violation of O.C.G.A. § 16-10-20, and face criminal
penalties as allowed by such criminal statute.
Signature of Applicant
Subscribed and sworn to before me
This the day of , 20 .
(Signature of Notary Public)
Printed Notary Name
My commission expires:
___________________________________________________________________________________________________________
For Office Use Only
Notification Meets all Requirements for License Type Held
Notification does NOT meet Requirements for License Type Held
Notification Received by Investigator _____________________________________ Date Received _________________
Print Name Time Date Stamp
Received by Investigator _____________________________________
Signature Name
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Alcoholic Beverage Off Premises CateringAncillary Tasting Event Notification (City of South Fulton)

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Completed 2 August 2020

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