STATE OF NEW JERSEY
DEPARTMENT OF LAW AND PUBLIC SAFETY
DIVISION OF ALCOHOLIC BEVERAGE CONTROL
P.O. BOX 087, 140 EAST FRONT STREET
TRENTON, NJ 08625-0087
APPLICATION FOR SPECIAL PERMIT FOR HOME MANUFACTURE OF
MALT ALCOHOLIC BEVERAGES [BRW]
(AT INSTRUCTIONAL FACILITY ONLY)
This permit will authorize the manufacture of up to 200 gallons of malt alcoholic beverages (beer, ale, stout,
porter) for personal consumption only. Product manufactured under the authority of this Permit may not be
sold nor may it be used for any purpose other than personal consumption at the address which appears
below, by the permittee, his/her family and their bona-fide guests. This application must be accompanied by a
fee of $15.00 in the form of a check or money order payable to the Division of A.B.C.
1. Name of Licensed Instructional facility:_____________________________________________________________
2. Address of Licensed Premises: _________________________________________________________________
___________________________________________________________________________________________
3. 12 Digit License Number: __________-___39___-__________-__________
[ ] New Applicant [ ] Renewal – Permit Number __________________
4. Which date are you scheduled to start? _____________________ Expected to finish? ______________________
5. Full Name of Applicant:_________________________________________________________________________
6. Age of Applicant: ____________
7. Permanent Residential Address of Applicant: _______________________________________________________
____________________________________________________________________________________________
8. Applicant’s Telephone No. (______)- _________-_________
9. Email Address: _______________________________________________________________________________
10. Do you own or are you an employee of an Alcoholic Beverage Licensed Business in New Jersey?
Yes
☐ No ☐
If yes, identify the license and the exact nature of such interest:
12 Digit License Number: __________-________-__________-__________
Nature of interest: ____________________________________________________________________________
_______________________________________ _____________________
Signature of Applicant Date
SIGNATURES MUST BE ORIGINAL, SCANS AND PHOTOCOPIES WILL NOT BE ACCEPTED
ALL PERMITS ARE MAILED TO LICENSED FACILITY
NOTE: If you are not participating in classes at a licensed instructional facility, you no longer need
this permit to manufacture at home for personal use
.
1583 Livingston Ave. Ste. 2 North Brunswick, NJ 08902
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