A
LCOHOLIC BEVERAGE CONTROL
109 SW 9
th
STREET
P.O. BOX 3506
T
OPEKA KS 66601-3506
STATE OF KANSAS
DEPARTMENT OF REVENUE
P
HONE: 785-296-7015
F
AX: 785-296-7185
www.ksrevenue.org/abc.html
Notification
A report will be submitted to the Division of Alcoholic Beverage Control for review of potential
administrative action against the license, which is separate from any alleged criminal violation.
Licensee copy
Business Name
Liquor license number
Date/time of alleged violation
Description of alleged violation
Name of person in charge*
*K.S.A. 41-106(e) defines person in charge as any individual or employee present on the licensed premises at the time of the
alleged violation who is responsible for the operation of the licensed premise. If no designated individual or employee is in charge,
then any employee present is the person in charge.
Position of person in charge
Law Enforcement Officer Name Agency Name ORI# Date
Signature of Person Receiving This Notice Date
Detach and Submit to ABC
Business Name
Liquor license number
Date/time of alleged violation
Description of alleged violation
Name of person in charge*
Position of person in charge
Law Enforcement Officer Name Agency Name ORI# Date
Signature of Person Receiving This Notice Date
INSTRUCTIONS TO LAW ENFORCEMENT
1. Notification must be given to the person in charge of the licensed premise at the time of the alleged violation.
2. Once the form is completed, email to KDOR_LAA@ks.gov or fax to the number above with a copy of your report.
ABC-60 (Rev. 02/18)
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