Application For License To Serve Fermented Malt Beverages & Intoxicating Liquors

Notice of Applicable Laws

This application is subject to the provisions of Wisconsin Statutes Chapter 125 (Alcohol Beverages) and Village of North Hudson Municipal Code Chapter [6– Alcoholic Beverages]. By submitting this application, you acknowledge that you have reviewed and understand these laws and agree to comply with them at all times. Current versions of the applicable laws can be accessed here:

License Duration

Alcohol beverage licenses issued by the Village of North Hudson shall be valid for a term of two (2) years.

(1) New Licenses. For new alcohol beverage license applications, the license term shall begin on the date the license is issued. The first license year shall run from the date of issuance through June 30 of that year. The second license year shall run from July 1 through June 30 of the following year.

(2) Renewal Licenses. For renewal alcohol beverage license applications, the two-year license term shall begin on July 1 and shall expire on June 30 two (2) years thereafter.

First name

Middle Name

Last name

Date of Birth

Month

Day

Year

Address

City

State

Zip Code

Phone

Driver's License Number

State of Driver's License

Have you held a Driver's License in a Previous State?

Yes

Is this Operator's license application new or a renewal?

New (or Renewal of expired license from MORE than 2 years ago)

Renewal

1) Have you been convicted of any felony or misdemeanor level crime?

Yes

2) Have you been convicted of violating any license law or ordinance regulating the sale, distribution, or use of fermented malt beverages or intoxicating liquors?

Yes

3) Have you been found guilty of traffic violations involving alcohol (i.e. OWI, DWI, test refusal, open container)?

Yes

Which North Hudson establishment are/will you be employed at?

Applicant Certification and Authorization

By signing this application, I certify that all information I have provided is true, complete, and accurate to the best of my knowledge. I acknowledge that I have reviewed and am familiar with all applicable federal, state, and local laws, ordinances, and regulations governing the sale of alcoholic beverages, and I agree to comply with them at all times.

I understand that providing false, misleading, or incomplete information, or failing to provide requested information, may result in the denial, suspension, or revocation of any license issued pursuant to this application.

I hereby authorize the Village of North Hudson to conduct any background checks necessary to verify the information in this application, including but not limited to criminal history, driving record, and licensing history. I release the Village, its elected officials, officers, employees, and agents from liability for the good-faith use of any information obtained in connection with this background check, except as otherwise prohibited by law.

I understand that all application fees are non-refundable, regardless of whether the license is approved or denied.

Signature Acknowledgment: By typing/signing my name below, I acknowledge that this constitutes my electronic signature and that I agree to the terms and conditions stated above.

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Today's Date

Product

Operator 's/Bartender's License$30