Please Reference the first two pages of your TABC application to be sure you fill out this form correctly.
ALL FIELDS REQUIRED!
Application has been made with the Texas Alcoholic Beverage Commission for a:
License/Permit Types:
Check all that apply:
(Permit/License Type. See #1 on Sample)

Bonded Warehouse Permit (J/JD)
Branch Distributor's License (BC)
Brewer's License (B)
Brewer's Self-Distribution License (SD)
Brewpub License (BP)
Carrier's Permit (C)
Consumer Delivery Permit (CD)
Distiller's and Rectifier's Permit (D)
Food and Beverage Certificate (FB)
Forwarding Center Authority
General Class B Wholesaler's Permit (X)
General Distributor's License (BB)
Late Hours Certificate (LH)
Local Cartage Permit (E)
Local Distributor's Permit (LP)
Manufacturer's Agent's Warehousing Permit (AW)
Mixed Beverage Permit (MB)
Nonresident Brewer's License (BN)
Nonresident Seller's Permit (S)
Out-of-State Winery Direct Shipper's Permit (DS)
Package Store Permit (P)
Passenger Transportation Permit
Private Club Exemption Certificate (NE)
Private Club Malt Beverage and Wine Permit (NB)
Private Club Registration Permit (N)
Promotional Permit (PR)
Retail Dealer's Off-Premise License (BF) (Malt Beverage)
Retail Dealer's On-Premise License (BE) (Malt Beverage)
Third-Party Local Cartage Permit (ET)
Water Park Permit (WP)
Wholesaler's Permit (W)
Wine and Malt Beverage Retailer's Off-Premise Permit (BQ)
Wine and Malt Beverage Retailer's Permit (BG)
Wine-Only Package Store Permit (Q)
Winery Permit (G)

Name of Inc., LLC or Name of Applicant/Member:
(Entity/Corp. Name -- See #2 on Sample)
Business Name or DBA (Doing Business As):
(DBA Name -- See #3 on Sample)
Address of Business: FORMAT: Street Address, City, Dallas County, Texas Zip Code
Do not forget to list the name of the COUNTY where the business resides.

(Address -- See #4 on Sample)
Members/
Managers/
Officers/Etc:

(One per line)
(Full Name - Title)                (See #5 on Sample)

NOTICE: By checking this box I acknowledge that I have read and understand that the Daily Commercial Record does not offer refunds for any form of subscription including email.

The TABC notice will publish for two consecutive business days as required by TABC regulations.

The fee is a flat fee of $200.00.

All TABC affidavits will be emailed to customer on the last date of publication. Please provide accurate email for delivery.


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