Liquor Liability Application

Please fill out the form below and hit the submit at the bottom of the page.

To download a printable version of the application, click here

Liquor Liability Application
4. Hours of Operation
a. Restaurant
b. Bar
5. Annual Sales
b. On premises
c. Catering
d. Alcohol Sales Percentage
%
%
%
9. Seating capacity
11. Approximate age mix of customers
%
%
%
13. Bar customer mix
%
%
%
Manufacturing Risk Information
Distributor Risk Information
Retailer Risk Information
4. Type of alcohol sold
%
%
%
License Information
Loss History & Prior Carrier Information