ALCOHOLIC BEVERAGE CONTROL
109 SW 9
th
STREET
P.O. BOX 3506
TOPEKA KS 66601-3506
STATE OF KANSAS
DEPARTMENT OF REVENUE
P
HONE: 785-296-7015
F
AX: 785-296-7185
www.ksrevenue.org/abc.html
BYOB Report
Law Enforcement Agency ORI
Law Enforcement Agency Name
Officer Name and Badge/ID No.
Business Name
Business Street Address
Business City, State and Zip
Owner of Business
Business Type (check all that apply):
Adult retail store Former 3.2 beer licensed premises
After hours bar Massage parlor
Art studio Movie theatre
Barber shop Music performances
Beauty salon Nail salon
Biker bar Restaurant
Cigar bar Social club
College bar Spa
Fast food restaurant Stadium
Former ABC-licensed premises Strip bar
Other s
pecify:
Description of problems (if any):
INSTRUCTIONS TO LAW ENFORCEMENT
1. Use this form to report any issues pertaining to the BYOB law to the ABC.
2. Once the form is completed, email to KDOR_LAA@ks.gov or fax to the number above with a copy of your report, if
applicable.
ABC-61 (Rev. 02/18)