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Updated 3/27/2026 NEW RENEWAL Application for Alcoholic Beverage License *NOTE: All applicants must first obtain a Pickens County Business License. Date of Application: Business Name: License Holder Name: Physical Address: Mailing Address: Contact Number: Email: Sales Tax ID Number: Application Type: Retail Package – Malt Beverage (Beer) Retail Package – Wine Retail Package – Malt Beverage (Beer) and Wine Combination On Site Consumption – Malt Beverage (Beer) and Wine Combination On Site Consumption – Distilled Spirits Farm Winery Farm Winery – Tasting Room By signing below, I swear or affirm that the facts contained herein together with the information contained in the attached exhibits to this application are true and correct. Date License Holder Signature (Applicant) Sworn to and subscribed before me this day of Notary Public ---PAGE BREAK--- Updated 3/27/2026 Alcohol Licence Application Acceptance and Acknowledgement ➢ Distilled spirits and farm winery license holders shall be required to prepare and deliver reports/returns as determined by the licensing board to aid and assist it in the determination and collection of excise taxes and for the enforcement of this chapter. A excise tax shall be levied upon the sale of purchase of alcoholic beverages for these license holders. The amount of said tax shall be determined by resolution of the county board of commissioners. ➢ Excise tax shall be collected by the license holder and remitted to the licensing board on or before the 20th of each month or as set by the county board of commissioners. Each remittance of said tax shall be accompanied by a report/return completed by the license holder upon forms created by the licensing board. ➢ Failure to remit taxes or file reports/returns when due with the licensing board shall result in a fine not to exceed $1,000.00, license forfeiture, or both; all unremitted taxes shall bear interest at ten percent. ➢ The licensing board shall be responsible for the collection of said tax, promulgating rules and regulations for said collection, and levying fines and/or license forfeiture. ➢ All license holders shall be required to prepare and deliver quarterly reports/returns as determined by the licensing board to aid and assist in the enforcement of this chapter. Reporting information shall include quarterly statistics such as food sales; beer, wine, and distilled spirits sales; total alcohol sales; and/or total retail sales. ➢ All license holders shall submit quarterly reports/returns using forms created by the licensing board. These reports/returns shall be due no later than the 10 th day of the month following the quarter. As an example, quarterly reports/returns for the first quarter period of January through March shall be due no later than April 10 or as set by the county board of commissioners. ➢ Permitted hours of sale are 7:00 a.m. until 11:45 p.m. Monday through Saturday (all license holders) and 12:30 p.m. until 11:30 p.m. on Sunday (retail package license holders only). No sales are permitted on Easter or Christmas. By signing below, I affirm that I have read and agree to the above regulations as set forth by Pickens County Ordinances, Chapter 6. Signature of Applicant Date ---PAGE BREAK--- Updated 3/27/2026 Affidavit Verifying Status for a Pickens County Public Benefit Application Please complete, notarize and return this affidavit with your license application or renewal. By executing this affidavit under oath, as an applicant for a Pickens County Alcohol License as referenced in the Georgia Security and Immigration Compliance Act (O.C.G.A. Section 50-36-1), I am stating the following with respect to my application for a Pickens County Business License. I hereby affirm and swear that: I am a United States citizen OR I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non- immigrant under the Federal Immigration and Nationality Act 18 years of age or older and lawfully present in the United States. In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section 16-10-20 of the Official Code of Georgia. Name of Business Date Signature of Applicant (name of natural person applying on behalf Alien Registration number for non-citizens of individual, business, corporation, partnership or other private entity) Printed Name SUBSCRIBED AND SWORN BEFORE ME ON THIS THE, DAY OF Notary Public My Commission Expires: *Note: O.C.G.A. 50-36-1(e)(2) requires that aliens under the federal Immigration and nationality Act, Title 8 U.S.C., as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of “alien”, legal permanent residents must also provide their alien registration number. NON-CITIZENS NEED TO INDICATE THE DOCUMENT BELOW THAT VERIFIES YOUR RESIDENCY STATUS AND ATTACH A COPY OF THE DOCUMENT (front and back) I-327 (Reentry Permit) Machine Readable Immigrant Visa I-551 (Permanent Resident Card) Temporary I-551 Stamp (on passport or I-94) I-571 (Refugee Travel Document) I-94 (Arrival/Departure Record) I-688 (Temporary Resident Card) Unexpired Foreign Passport I-688A (Employment Authorization Card) I-20 (Certificate of Eligibility for Nonimmigrant I-688B (Employment Authorization Document) (F-1) Student Status) I-766 (Employment Authorization Card) DS2019 (Certificate of Eligibility for Exchange Visitor Certificate of Citizenship (J-1) Status) Naturalization Certificate Other (Use Document Description) ---PAGE BREAK--- Updated 3/27/2026 Required Items to be Completed and/or Attached to this Application ➢ Fingerprinting must be completed at Pickens County Sheriff’s Office. Per Pickens County Code of Ordinances section 6-7 As a prerequisite to the issuance of any such new license, the applicant shall furnish a complete set of fingerprints to be forwarded to the Georgia Bureau of Investigation The federal or state record, if any, shall be obtained and returned to the governing authority submitting the fingerprints. No license shall be issued to a person or entity owned or managed by a person who has been convicted of a crime involving moral turpitude or a violation of any federal, state, or local statute or ordinance involving alcoholic beverages within the two years immediately preceding the filing of an application. Any license holder arrested for said crime(s) shall be required to report the same to the licensing board. ▪ For renewal applications, a background check must be completed by Pickens County Sheriff’s Office, and the form must be submitted with renewal applications. ➢ Submit copy of recorded Warranty Deed or Lease Agreement ➢ Submit copy of property tax bill ➢ Submit copy of tax map ➢ List zoning and verify with Planning & Development staff that the property is currently zoned for the intended use (restaurant, gas/service station, special events venue, winery, etc.) ➢ Provide evidence of compliance with Ordinance 6-11 requiring at least 600 feet distance from the front door of the structure from which malt beverages and/or wine will be offered for sale in a straight line to the nearest sidewalk, walkway, or street/road/highway; along such sidewalk, walkway, or street/road/highway; to the land (property) line of any school property, educational property, college campus property, or church property. ➢ Submit photos of all four sides of the building to be used in the sale of alcoholic beverages ➢ If the applicant is a corporation or limited liability company, please provide a certificate of good standing issued by the Georgia Secretary of State’s office and the company authorization for the individual signer of the application to execute the same for the company. If the applicant is an individual, please provide a copy of driver’s license or State-issued identification. ➢ For Farm Winery applications, provide a copy of Federal License and physical address of Tasting room. ---PAGE BREAK--- Updated 3/27/2026 Legal Ad Please attach a copy of legal ad and Publisher’s Affidavit to this application verifying that it ran for the four consecutive weeks in the Pickens Progress prior to filing the application. Below are examples of notices. If you are applying for a combination of alcohol licenses, you may need to use a modified version of one of these ads: NOTICE OF INTENT TO APPLY FOR A LICENSE TO SELL BEER AND WINE BY THE PACKAGE This is to give public notice of the intent of LICENSE HOLDER NAME to make application for BUSINESS NAME to the Beer & Wine Board of Pickens County for a license to sell beer and wine by the package at 123 PHYSICAL ADDRESS WAY, JASPER, GA 30143. NOTICE OF INTENT TO APPLY FOR A LICENSE TO SELL BEER AND WINE BY POURING This is to give public notice of the intent of LICENSE HOLDER NAME to make application for BUSINESS NAME to the Beer & Wine Board of Pickens County for a license to sell beer and wine by pouring at 123 PHYSICAL ADDRESS WAY, JASPER, GA 30143. NOTICE OF INTENT TO APPLY FOR A LICENSE TO SELL DISTILLED SPIRITS BY POURING This is to give public notice of the intent of LICENSE HOLDER NAME to make application for BUSINESS NAME to the Beer & Wine Board of Pickens County for a license to sell distilled spirits by pouring at 123 PHYSICAL ADDRESS WAY, JASPER, GA 30143. NOTICE OF INTENT TO APPLY FOR A LICENSE TO SELL BEER, WINE, AND DISTILLED SPIRITS BY POURING This is to give public notice of the intent of LICENSE HOLDER NAME to make application for BUSINESS NAME to the Beer & Wine Board of Pickens County for a license to sell beer, wine, and distilled spirits by pouring at 123 PHYSICAL ADDRESS WAY, JASPER, GA 30143. ---PAGE BREAK--- Updated 3/27/2026 Fee Schedule Revised June 23, 2015 NEW RENEWAL Retail Package – Malt Beverage (Beer) $800.00 $775.00 Retail Package – Wine $800.00 $775.00 Retail Package – Malt Beverage (Beer) and Wine $1600.00 $1550.00 On Site Consumption – Malt Beverage (Beer) and Wine $1600.00 $1550.00 On Site Consumption – Distilled Spirits $3075.00 $3075.00 Farm Winery $1600.00 $1500.00 Farm Winery – Tasting Room (One-Time Fee) $750.00 Special Event (Per Event) $100.00 Per Ordinance Sec. 6-14, “Excise tax shall be collected by the license holder and remitted to the licensing board on or before the 20th of each month Each remittance of said tax shall be accompanied by a report/return completed by the license holder upon forms created by the licensing board.” Excise Tax Amounts: Distilled Spirits – three percent of the Gross Sales of Distilled Spirits Wine – eighty cents ($0.80) per gallon of wine sold (based on $0.00625 per ounce)