Form L-ON (09/2019)
Are you, the applicant a veteran-owned business? Yes No
Are you, the applicant a Historically Underutilized Business (HUB)? Yes No
As indicated on the chart, enter the individuals that pertain to your business type:
(For additional space, use Form L-OIC)
Limited Liability Company/All Officers or Managers
Limited Partnership/All General Partners
City, County, University/Official
Section 109.31 et seq.
Will your business be located within 300 feet of a church or public hospital? Yes No
NOTE: For churches or public hospitals measure from front door to front door, along the property lines of the street fronts and in a
direct line across intersections.
Will your business be located within 300 feet of any private/public school, day care or child care facility? Yes No
If “YES,” are the facilities located on different floors or stories of the building? Yes No
For private/public schools, day care centers and child care facilities measure in a direct line from the nearest property line of
the school, day care center or child care facility to the nearest property line of the place of business, and in a direct line
For multistory building: businesses may be within 300 feet of a day care center or child care facility as long as the facilities
are located on different floors of the building.
If located on or above the fifth story of a multistory building: measure in a direct line from the property line of the private/public
school to property line of your place of business in a direct line across intersections vertically up the building at the property
line to the base of the floor on which your business is located.
Will your business be located within 1,000 feet of a private school? Yes No
Will your business be located within 1,000 feet of a public school? Yes No
If required under Section 11.391 and 61.381, enter the exact date the 60-Day sign was posted
at your location.
19. IF YOUR LOCATION IS NOT WITHIN THE CITY LIMITS, CHECK HERE
I, the applicant, have confirmed I am not located in the city limits of any city, therefore, city certifications are not
COMPLETE THE FOLLOWING CHECKLIST BEFORE SUBMITTING YOUR APPLICATION
Per Sec. 102.01, a tied house is defined as any overlapping ownership between those engaged in the alcoholic beverage
industry at different levels of the three-tier system. No person having an interest in a permit issued by TABC may secure or
hold, directly or indirectly, an ownership interest in a business on a different level.
All required forms have been completed.
I have reviewed all forms to ensure they are complete.
I have obtained all required local and state certifications (pages 3-5).
All application packets have been notarized.
Phone numbers and email address for Contact Person are up to date.
All additional documentation as required by the application packets is attached
If required, out of state criminal history checks are attached (PHS #7).
Certification of publication in local newspaper has been completed (page 5).
A copy of the newspaper publication is attached (page 5).