Department of Alcoholic Beverage Control
DAILY LICENSE APPLICATION/AUTHORIZATION - Non Transferable
LICENSE NUMBER GEO CODE
RECEIPT NUMBER
FEE
$
1. ORGANIZATION'S NAME CONDITIONS REQUIRED DIAGRAM REQUIRED
Yes No Yes No
2. LICENSE TYPE (Check appropriate license type AND organization type)
a.
Daily General ($75.00)
(Includes beer, wine and distilled spirits)
Political Party/Affiliate Supporting Candidate for Fraternal Organization in Existence Over Five Years
Public Office or Ballot Measure with Regular Membership
Organization Formed for Specific Charitable or Civic Purpose Religious Organization
Other: Vessel per Section 24045.10 B&P ($50.00)
b. Special Daily Beer & Wine ($50.00)
Charitable Fraternal Social Political Other:
Civic Religious Cultural Amateur Sports Organization
c. Special Temporary License ($100.00) (Different privileges depending on statute)
Television Station per Section 24045.2 or 24045.9 B&P
Person conducting Estate Wine Sale per Section 24045.8 B&P
Nonprofit Corporation per Sections 24045.4 and 24045.6 B&P Women's Educational and Charitable Organization per
Section 24045.3 B&P
Other Special Temporary Licenses, per Section
License number Amount $
3. EVENT TYPE
Dinner Dance Wedding Lunch Picnic Barbeque Social Gathering Festival
Sports Event Concert Birthday Mixer Carnival Dinner Dance Other:
4. TOTAL # OF DAYS 5. ESTIMATED ATTENDANCE 6. HOURS OF ALCOHOLIC BEVERAGE SALES, SERVICE AND/OR CONSUMPTION
From To
7. EVENT DATE(S) 8. EVENT IS OPEN TO THE PUBLIC
Yes No
9. EVENT LOCATION (Give facility name, if any, street number and name, and city)
10. LOCATION IS WITHIN THE CITY LIMITS 11. TYPE OF ENTERTAINMENT 12. SECURITY GUARDS
Yes No Yes No If yes, how many?
13. AUTHORIZED REPRESENTATIVE'S NAME 14. REPRESENTATIVE'S TELEPHONE NUMBER
15. REPRESENTATIVE'S ADDRESS
16. ORGANIZATION'S MAILING ADDRESS (If different from #15 above)
17. AUTHORIZED REPRESENTATIVE'S SIGNATURE 18. DATE SIGNED
PROPERTY OWNER APPROVAL BY (Name), REQUIRED PHONE NUMBER PROPERTY OWNER SIGNATURE DATE SIGNED
LAW ENFORCEMENT APPROVAL BY (Name), IF APPLICABLE PHONE NUMBER LAW ENFORCEMENT SIGNATURE DATE SIGNED
DISTRICT OFFICE APPROVAL BY (Name) ABC EMPLOYEE SIGNATURE ISSUANCE DATE
State of California
Gavin Newsom, Governor
Instructions: Complete all items. Submit to local ABC District Office with required fee (Cashier's Check or
Money Order) payable to ABC. Once license is issued, fee cannot be refunded. For a listing of ABC District
Offices please visit http://www.abc.ca.gov/distmap.html
Pursuant to the authority granted by the organization named below, the undersigned hereby applies for the
license(s) described below.
The above-named organization is hereby licensed, pursuant to the California Business and Professions Code Division 9 and California Code of
Regulations, to engage in the temporary sale of alcoholic beverages for consumption at the above named location for the period authorized above.
This license may be revoked summarily by the Department if, in the opinion of the Department and/or the local law enforcement agency, it is
necessary to protect the safety, welfare, health, peace and morals of the people of the State.
ABC-221 (rev. 07/19)
