New Liquor Licence
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Proposed Trading Name
*
ABN
*
Licensee Name
*
This is the name the licence will be under which can be a sole trader, Partnership, Company and or Trust
Licensee Type
*
Sole Trader
Partnership
Company Only
Company with Trust
Trust Only
Other
Trust Name(s)
Phone Number
*
Please enter a valid phone number.
Postal Address
*
Email
*
example@example.com
Premises Address
*
What liquor products do you intent to sell (what particular type or range of liquor?)
*
What type of licence do you require
*
Sale via online transactions only (not produced)
Sale by wholesale liquor quantities (not produced over 4.5L per transaction)
Sale of Liquor produced only from home or administration office only
Cellar door sales from venue
Retail Liquor Merchant -Sale via a bottleshop on premises
Other
Do you own the property?
*
Yes
No
Name of the Landlord or Agent
*
First Name
Last Name
Landlord - Phone Number
*
Please enter a valid phone number.
Landlord - Email
example@example.com
How many Licensees, Partners, Directors, Shareholders or Adult Trust Beneficiaries need to be approved?
*
1
2
3
4
5 or more
Name of Licensee, Director Shareholder or Adult Trust Beneficiary (1)
*
First Name
Last Name
Email of Licensee, Director Shareholder or Adult Trust Beneficiary (1)
*
This email must be unique to the individual and have the correct spelling as this is where you will be sent a Personal Informatio Declaration form (It can't be changed later)
Phone Number (Person 1)
Please enter a valid phone number.
Address (1)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth (1)
*
-
Day
-
Month
Year
Date
Name (Person 2)
First Name
Last Name
Email - (Person 2)
This email must be unique to the individual and have the correct spelling as this is where you will be sent a Personal Informatio Declaration form (It can't be changed later)
Phone Number (Person 2)
Please enter a valid phone number.
Date of Birth - (Person 2)
-
Day
-
Month
Year
Date
Address - (Person 2)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name (Person 3)
First Name
Last Name
Email (Person 3)
This email must be unique to the individual and have the correct spelling as this is where you will be sent a Personal Informatio Declaration form (It can't be changed later)
Phone Number (Person 3)
Please enter a valid phone number.
Address (Person 3)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth ( Person 3)
-
Day
-
Month
Year
Date
Name ( Person 4)
First Name
Last Name
Email (Person 4)
This email must be unique to the individual and have the correct spelling as this is where you will be sent a Personal Informatio Declaration form (It can't be changed later)
Phone Number (Person 4)
Please enter a valid phone number.
Address (Person 4)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth (Person 4)
-
Day
-
Month
Year
Date
If there are any more licensees, directors, shareholders or Adult Trust Beneficiaries please provide the details here
Name, Address, Email and Date of Birth
Is anyone to be approved or related to any one to be approved (ie close associates) ever been charged with any criminal offences, has any charges pending or been declared bankrupt?
*
Yes
No
Unsure
Has anyone to be approved lived overseas for a continuous period of more than 12 months since they turned 18
*
Yes
No
Unsure
When do you anticipate starting the business?
*
-
Day
-
Month
Year
Date
Trading Hours (please note these need to be your maximum hours of trade if you intend to open earlier or later the hours need to reflect this)
*
Proposed Venue Capacity
*
Do you require outdoor dining
*
Yes - However it is part of the leased property
Yes - It is on Council land and an outdoor permit is required
No
Do you require Approved Market consent on your licence? (additional $143 government fee applies)
*
Yes
No
Has Council Approval been obtained?
*
Yes
No
Unsure
Number of Toilets
*
Do you have floor plans
*
Yes
No
Please refer me to someone to get them done
Other
Do you have Business Insurance
*
Yes
No
Would you like Lion Consulting to provide you with a quote? (We are specialists in Hospitality Insurance)
*
Yes
No
Maybe later
How did you hear about us?
*
Google
Referral
Other
Who were you referred by?
Other Information
File Upload - Floor plans or other relevant docs
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