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Celestine Muoneke
Celestine Muoneke

Off Premises-Retail Beer and Wine License (NY)

 
 


LOGIN INFORMATION
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Email*:
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PLEASE SELECT SUBSCRIPTION TYPE
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PLEASE SELECT
State*:
County*:
Type of Entity*:
 
ORDER INFORMATION
Infotax Square Fee for Filing Your Retail Beer and Wine License: $
State-City-County Fees Not Included
Total: $
Reseller Discount: $
Total: $
CONTACT INFORMATION (This is where we will ship your documents)
First Name*:
Last Name*:
Address*:
Suite/Apt:
City*:
State*:
Zip*:  (99999) OR (99999-9999)
County*:
Phone*:
Fax:
 
BUSINESS OVERVIEW
Is it a new business? Yes No
Name of Entity*:
DBA/Trade Name (if any):
State of Formation*:
Date of Formation*:  (mm/dd/yyyy)
Date Business Planning to Start*:
it can be a future date (mm/dd/yyyy)
Employer ID Number*:
Copy Address from Contact Information if same
Address*:
(P O BOX address is not acceptable)
Suite/Apt:
City*:
State*:
Zip*:  (99999) OR (99999-9999)
County*:
Business Type:
Business Description*:
Do you have any Felony?*: No Yes
Do you owe any Beer & Wine Taxex to the state?*: No Yes
Do you have any Criminal History? *: No Yes
Did you ever apply for the same busness?*: No Yes
Are you adding a new location?*: No Yes
Are you purchasing or acquiring an existing business?*: No Yes
Sell products or services at retail (to consumers)?*: No Yes
Sell products or services at wholesale
(to registered dealers who will sell to consumers)? *: 		No Yes
Purchase or sell second hand goods?*: No Yes
Do you own or rent the place?
Provide Lease/Occupancy License)*: 		No Yes
 
 
OFFICERS/MEMBERS INFORMATION
OFFICER 1
  Same as Contact Information
Full Name*:
Title*:
Driving License Number: (if any)
Driving License State:
Social Security Number*: (999-99-9999)
Percentage of Ownership*:
Date of Birth*:  (mm/dd/yyyy)
Hair Color?
Eyes Color?
Height?
Weight?
Race?
Residence Address*:
City*:
State*:
Zip*:  (99999) OR (99999-9999)
County*:
Phone:
Fax:
OFFICER 2 
Full Name:
Title:
Driving License Number: (if any)
Social Security Number: (999-99-9999)
Percentage of Ownership:
Date of Birth:  (mm/dd/yyyy)
Hair Color?
Eyes Color?
Height?
Weight?
Race?
Residence Address:
City:
State:
Zip:  (99999) OR (99999-9999)
County:
Phone:
Fax:
OFFICER 3 
Full Name:
Title:
Driving License Number: (if any)
Social Security Number: (999-99-9999)
Percentage of Ownership:
Date of Birth:  (mm/dd/yyyy)
Hair Color?
Eyes Color?
Height?
Weight?
Race?
Residence Address:
City:
State:
Zip:  (99999) OR (99999-9999)
County:
Phone:
Fax:
PAYMENT INFORMATION
  Same as Contact Information
First Name*:
Last Name*:
Billing Address*:
City*:
State*:
Zip*:  (99999) OR (99999-9999)
Phone*:
Fax:
Card Type*:
Expiration Date*:
Card Number*:
Card Security Code*:
Please use the security code as follow:

1. Master Card- Please insert 3 digits security code from the back of the card
2. Visa Card- Please insert 3 digits security code from the back of the card
3. Discover Card- Please insert 3 digits security code from the back of the card
4. American Express- Please insert 4 digits security code from the front of American Express

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