THIS RENEWAL FORM CANNOT BE USED IF:
1. Thereisachangeinbusinessentity(i.e.,individualhas
changedtopartnershiporcorporation/limited liability
company;partnershipchangedtoindividualorcorpo-
ration/limitedliabilitycompany;corporationchangedto
individual, partnership or limited liability company) and
if limited liability company has been dissolved.
2. Partners are added or dropped.
3. Application is made in a different municipality.
PARTNERSHIPS:
Indicatefullnameandhomeaddressofeachpartner.One
partnermustsignapplication.Reminder: If partners have
been added or dropped since your last application, you must
useFormAT-106(OriginalBeverageLicenseApplication).
CORPORATIONS:
Oneofficermustsignapplication.BesuretoanswerQues-
tionNo.7byindicatinganychangeofofficers,directors,
and/orchangesinhomeaddress.Ifthereareanychanges
in officers and/or directors each must complete Form AT-
103(AuxiliaryQuestionnaire).Iftherehasbeenachange
inagentsinceyourlastapprovedagent,he/shemustcom-
pleteFormsAT-104(ScheduleforAppointmentofAgent)
ANDAT-103(Auxiliary Questionnaire)inaddition tothis
(AT-115) form.
Instructions for Renewal Alcohol Beverage License Application
LIMITED LIABILITY COMPANY:
Onemember/managermustsignapplication.Followpro-
cedure under Corporations for any change of members
oragent.
NOTE:Useinkortypewriterwhenfillinginapplications.
Besuretoanswerallquestionsfullyandaccurately.Any
lackofaccesstoanyportionofalicensedpremisesduring
inspection will be deemed a refusal to permit inspection.
Suchrefusalisamisdemeanorandgroundsforrevocation
of this license.
DISCRIMINATION CLAUSE – (City of Milwaukee only)
The applicant shall not willfully refuse to provide those
services offered under this license or refuse to employ or
dischargeanypersonotherwisequalifiedbecauseofrace,
color,creed,sex,nationaloriginorancestry,theapplicant
shall not seek information as a condition of employment,
orpenalizeanyemployeeordiscriminateintheselection
ofpersonnelfortrainingorpromotionsolelyonthebasisof
such information. The applicant also shall not discriminate
againstanymemberofthemilitaryservicedressedinuniform
bywillfullyrefusingservicesofferedunderthislicense.
Complete,signandreturnthisformtotheclerk.
Ifanswerto QuestionsNo.6aand/or6bonpage 2are
“YES,” outline details below:
CONVICTIONS
1. NAME STATUTENO./LOCALORDINANCE
CHARGE WHERECONVICTED
DATE PENALTY MISDEMEANOR FELONY
2. NAME STATUTENO./LOCALORDINANCE
CHARGE WHERECONVICTED
DATE PENALTY MISDEMEANOR FELONY
3. NAME STATUTENO./LOCALORDINANCE
CHARGE WHERECONVICTED
DATE PENALTY MISDEMEANOR FELONY
PENDING CHARGE
1. NAME STATUTENO./LOCALORDINANCE
PENDING CHARGE DATE
AT-115 (R. 5-19)
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