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LEGAL NOTICE
FORMAT FOR PUBLICATION OF ORIGINAL PERMIT APPLICATION
Check Applicable Phrases
I,
(Sole Owner’s Name)
We, the partners of
(Partnership Name)
We, the officers of
(Corporation Name)
I/We, the member(s) of
(Limited Liability Company Name)
I, the trustee of
(Name of Trust)
Intend to make application for:
( ) a Manufacturer Class I, Distiller &or/ Rectifier permit
( ) a Manufacturer Class II, Wine permit
( ) a Manufacturer Class III, Native Wine permit
( ) a Package Retailer permit
( ) an On-Premise Retailer permit
( ) an On-Premise Retailer, Club permit
( ) an On-Premise Retailer, Wine only permit
( ) a Common Carrier permit
( ) a Native Wine Retailer permit
( ) a Caterer’s permit, for on-premise retailer permit holders
( ) a Caterer’s permit
( ) a Solicitor’s permit
( ) a Research permit
( ) a Merchant permit
( ) a Special Service permit
( ) an event venue permit
As provided for by the Local Option Alcoholic Beverage Control Laws, Section 67-1-1, et seq., of the Mississippi Code of 1972,
Annotated. If granted such permit, I or We propose to operate as a
( ) sole owner
( ) partnership
( ) corporation
( ) limited liability company
( ) trust
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Under the trade name of
Located at
(Street) (City) (County)
The name(s), title(s) and address(es) of the owner(s)/partners/corporate officer(s) and/or majority stockholder(s)/ member(s)/ trustee
of the above named business are:
If any person wishes to request a hearing to object to the issuance of this permit a request for a hearing must be made in writing
and received by the Department of Revenue within (15) fifteen days from the first date this notice was published.
Requests shall be sent to:
Chief Counsel, Legal Division
Department of Revenue
P. O. Box 22828
Jackson, MS 39225
Date of First Publication: ____________________________________
This the______day of_________________, _______.
