Date:
License Number:
Fee Received:
Last Name:
First Name:
Middle Initial:
Corporate Name:
Reason Organized:
Date Business Was Established:
Fictitious Firm Name:
Date Firm Name Filed:
Business Location (Address):
Business Phone Number:
Mailing Address:
Home/Mobile Phone Number:
Date Liquor Sales Will Start:
City of Galva
311 N. W. 4th Avenue
Galva, IL 61434
Phone: (309) 932-2555
Fax: (309) 932-3306
www.galvail.gov
Liquor License
Application
Class A:
Page 1 of 3
Applicant's Information
Type of Liquor Sales (Check all that apply):
Retail sale on the premises specified, of alcoholic liquor for consumption on said premises as well as other retail sales of
such liquor, on all days except as otherwise specified by law -- Annual Fee $1,000.00
Class B:
Retail sale by not-for-profit clubs, nationally affiliated, on club premises, of alcoholic liquor for consumption on said
premises by members and their guests, on all days except as otherwise provided by law -- Annual Fee $500.00
Class C:
Class D:
Retail sale of draft beer and wines with alcoholic content no greater than 20% by establishments which serve prepared
and ready to eat food, such beer and wines to be served only with orders of such food and to be consumed only on said
premises. There shall be no bar or bar stools in such licensed premises -- Annual Fee $600.00
Retail sale of packaged liquor of all kinds -- Annual Fee $600.00
Class E:
Retail sale of packaged liquor of all kinds in an establishment physically located separate and apart from any other type
of retail business -- Annual Fee $800.00
Class F:
Retail sale of alcoholic beverages by bowling alleys. The sale of alcoholic beverages shall be incidental to the primary
function of the subject premises as a bowling alley. The alcoholic beverages shall be sold for consumption only on the
premises by patrons of the facility and their guests -- Annual Fee $800.00
Class G:
Retail sale of alcoholic beverages by the drink or pitcher only, for consumption on the premises only, in the course of a
rental hall business. Patrons cannot act as bartenders or otherwise dispense alcoholic liquor. When the premises are
used for the sale of alcoholic liquor, the licensee or a manager acting on behalf of the licensee must be on the premises
-- Annual Fee $250.00
Class H:
Retail sale of alcoholic beverages by a caterer or current holder of another class of liquor license in connection with the
sale of prepared food, for service at private parties, weddings or other similar events which are not open to the general
public, at a location other than the premises leased, owned, or otherwise operated by the licensee. The location of the
catered event shall be deemed the licensed premise. Gross revenue from the sale of alcoholic liquor at any event
catered by the holder of a Class H license shall not exceed forty percent (40%) of the total gross revenue generated from
the sale of alcohol and food at the event ("the forty percent rule"). An affidavit certifying compliance with the "Forty
Percent Rule" shall be submitted on a quarterly basis to the Liquor Commissioner. The holder of a Class H license may
enter into a contract with another individual or entity for food service at the catered event, so long as a copy of said
contract is available for inspection on the premises of the catered event for the entire length of the event. No catered
event by the holder of a Class H license shall exceed three days in length, nor shall alcoholic liquor be served at such
event for more than eight (8) consecutive hours -- Annual Fee $250.00
Page 2 of 3
Yes
No
Yes
NoYes
No
Yes
No
Do you agree to abide by all Federal laws?
Yes No
Do you agree to abide by all State laws?
Yes No
Do you agree to abide by all of Galva's municipal laws?
Yes No
Have you been convicted of keeping a house of ill fame?
Yes No
Have you been convicted for pandering?
Yes No
Are you a citizen of Galva, Illinois?
Yes
Have you been convicted of a crime of moral turpitude?
Yes No
List ALL owners, partners or corporate officers below (attach additional sheet if necessary):
1
3 4
2
Name:
Title:
Address:
Phone:
Name:
Phone:
Address:
Title:
Name:
Title:
Address:
Phone:
Name:
Title:
Address:
Phone:
No
If YES, Where?
Are you familiar with Illinois Liquor Laws?
If YES, date naturalized:
Place Naturalized:
Yes No
If YES, date convicted:
Place convicted:
Have you ever had a liquor license revoked for any reason?
Yes No
If YES, date revoked:
Reason revoked:
Have you obtained a performance bond ($750.00)?
Yes No
If NO, date bond will be with the City of Galva:
Have you ever obtained a liquor license before?
Are you a United States Citizen?
Are you a naturalized citizen?
Have you ever been convicted of a felony?
Page 3 of 3
If this application is made on behalf of a partnership, firm, association, club or corporation, then the same shall be signed and sworn to by
at least two (2) members of same or the president and secretary of said partnership, firm, association, club or corporation.
CERTIFICATION: I hereby certify that the information contained herein is true and correct to the best of my knowledge and belief. I
understand that this liquor license, if approved, may not be transferred to any other person, partnership, firm, association, club or
corporation, nor may it be transferred to any other location, without prior approval of the Liquor Commissioner. I further
understand that the investigation period may take forty-five (45) days or longer for processing.
Signature:
Signature:
Signature:
Signature:
Witnessed by:
Date:
Date:
Date:
Date:
Date:
FOR GALVA POLICE DEPARTMENT USE ONLY
210 Front Street
Galva, IL 61434
(309) 932 - 3911
File #:
Applicant:
Date Fingerprinted:
Fingerprinted by:
File #:
Applicant:
Date Fingerprinted:
Fingerprinted by:
File #:
Applicant:
Date Fingerprinted:
Fingerprinted by:
File #:
1
Applicant:
Date Fingerprinted:
Fingerprinted by:
2
43
Non-Refundable Investigation Fee: $75.00 Date Paid:
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