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MODESTO POLICE DEPARTMENT DAILY ALCOHOL PERMIT APPLICATION FEE PAID: MPD CASE NAME OF ORGANIZATION: BUSINESS Number/Street City State Zip Code BUSINESS PHONE NUMBER (DAY): (EVENING): APPLICANT INFORMATION MODESTO POLICE DEPARTMENT APPROVAL Administrative Services Supervisor Date RD BEAT Applicant Signature: Daily Alcohol Permit.pub 10/16/01 Issuing Officer: IBM#: EVENT INFORMATION LOCATION OF PERMITTED DATE: DAY: START TIME: am/pm END TIME: am/pm LIVE ENTERTAINMENT: TYPE: (Band/Singer/DJ, etc.) NAME OF ENTERTAINMENT: YES NO EXPECTED ATTENDANCE: AGE GROUP EXPECTED: TYPE OF DRINKING CONTAINERS: ACTUAL LOCATION OF BEVERAGE SERVICE ON PROPERTY: TYPE OF BEVERAGE BEING SERVED: (wine/beer/etc.) (SECURITY IS REQUIRED. Security is 1 Security Officer/100 expected attendance) NAME OF PRIVATE SECURITY SERVICE: ADDRESS: PHONE: NO. OF SECURITY PERSONNEL: PRIVATE SECURITY SERVICE MUST BE LICENSED WITH THE CITY OF MODESTO. A SIGNED SECURITY CONTRACT MUST ACCOMPANY THIS APPLICATION. NAME OF PERSON REQUESTING APPROVAL: ADDRESS: HM PH: BUS PH: DRIVERS LICENSE SIGNATURE: PERSON IN CHARGE MUST BE PRESENT AT EVENT WHILE LICENSE IS IN EFFECT I have read and familiar with the City of Modesto regulations pertaining to signs and hereby accept full responsibility for the removal of all signs, legal or illegal, regarding the event for which this application is made. Further, should the City of Modesto incur expenses with respect to the removal of said signs, I agree to pay all such costs including reasonable attorney’s fees should legal action occur. This form is for the Modesto Police Department’s approval of your “Daily Alcoholic Beverage License”. Final license approval will be made by the State of California Department of Alcoholic Beverage Control. The applicant must also comply with all other State and Local licensing requirements. DATE: TYPE OF ORGANIZATION: FRATERNAL CHARITY EMPLOYEE ASSN POLITICAL UNION OTHER NAME OF PERSON IN CHARGE OF EVENT: ADDRESS: HM PH: BUS PH: DRIVERS LICENSE SIGNATURE: PERSON IN CHARGE MUST BE PRESENT AT EVENT WHILE LICENSE IS IN EFFECT City of Modesto Business License City of Modesto Dance License/Permit Federal Employer Identification State Board of Equalization Sellers Permit ---PAGE BREAK--- MODESTO POLICE DEPARTMENT DAILY ALCOHOL PERMIT APPLICATION INSTRUCTION SHEET The application must be fully and legibly completed by the person requesting approval for the Daily Alcohol Permit. The application is only for the Modesto Police Department Approval of the permit. Final approval and licensing will be done by the State of California, Department of Alcoholic Beverage Control Board. This license is ONLY available to charitable or non-profit organizations. The applicant must complete or obtain the following prior to filing this application with the Modesto Police Department: 1. Obtain a City of Modesto Business License (No-charge to non-profit groups) Location: Finance Department, 2nd Floor, 1010 10th Street, Modesto 2. Obtain a City of Modesto Dance License/Permit (if applicable) Location: Finance Department, 2nd Floor, 1010 10th Street, Modesto 3. Obtain a Federal Employer ID Number. All charitable or non-profit organizations have or must have this number. Location: Internal Revenue Service, 1300 K Street, Modesto – 526-7738 4. Obtain a Sellers Permit . Location: State Board of Equalization, 31 East Channel Street, Rm 264, Stockton [PHONE REDACTED] This application must be submitted to the Administrative Services Unit, Modesto Police Department, 600 10th Street, Modesto – 572-9679. All the above information must be on the application prior to approval/denial by the Modesto Police Department. If the application is approved, the person requesting approval will be notified by phone, and a copy will be mailed to the organization’s address. The person requesting approval may also pick up the application in person. Once approval has been obtained you must have a representative of the organization contact: State of California, Alcoholic Beverage Control 31 East Channel Street, Room 168 Stockton, CA 95202 (209)948-7739 The State of California Alcoholic Beverage Control will either approve or deny the request.