Page 1 of 3 Form MB (08/2015) ** Renew Online at https://online

** Renew Online at https://online.tabc.texas.gov **
FORM MB
(08/2015)
APPLICATION FOR TWO-YEAR RENEWAL OF
MIXED BEVERAGE PERMIT (MB)
LICENSE/PERMIT NUMBER:
EXPIRES:
CAREFULLY READ ALL INSTRUCTIONS
1. Mailing Address:
2. Trade Name:
3. Location Address:
4. Mailing Address:
LICENSE/PERMIT NUMBER
ISSUE DATE
-
TWO-YEAR FEE
TWO-YEAR SURCHARGE
LATE FEE
TOTAL FEES DUE
-
BOND INFORMATION
REGISTRY NO.
5. Application is filed by:
This does not represent the entire business entity structure on file with the Texas Alcoholic Beverage Commission. The license/permit holder is
responsible for notifying TABC of any organizational changes at any level of your business structure. Failure to do so may result in the cancellation
of your license/permit.
QUALIFICATIONS
6. Is this application being made by you for the benefit of someone else? If “YES,” indicate below or attach
explanation.
6.
YES
NO
7. Has the applicant, applicant’s spouse, partner, officer, director or stockholders, of the licensed entity become
disqualified by law or by facts and conditions from holding a license or permit under the Texas Alcoholic
Beverage Code? If “YES,” indicate below or attach explanation.
7.
YES
NO
8. Have there been changes since your original application that have not been reported on this or previous
applications? If “YES,” indicate below or attach explanation.
8.
YES
NO
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Form MB (08/2015)
LICENSE/PERMIT NUMBER:
FORM MB
9. Provide sales data for the last year of operation or the projected yearly sales at the licensed premises:
Alcoholic Beverage Sales:
$
Other Sales:
$
Food Sales:
$
Total Sales:
$
FOR BREWPUBS (BP) APPLICANT ONLY
10. Do you, the applicant, intend to sell your alcoholic product to wholesalers/distributors?
10.
YES
NO
IMPORTANT: Sec. 28.081. SUBSTITUTION OF BRAND WITHOUT CONSENT OF CONSUMER PROHIBITED. (a) The holder of a mixed
beverage permit or a private club permit, or the agent, servant or employee of a holder of a mixed beverage permit or private club permit
commits an offense if the holder, agent, servant, or employee substitutes one brand of alcoholic beverage for a brand that has been
specifically requested by a consumer, unless the consumer is notified and consents to the substitution.
(b) A holder of a permit who violates Subsection (a) of this section is liable in a civil suit to a consumer for damages resulting from the
substitution. The court shall award the prevailing party in an action under this section attorney’s fees and costs of action.
APPLICANT CONTACT INFORMATION
Business Phone #
WARNING:
Alternate Phone #
Cell Phone # (optional)
E-mail (optional)
Sec. 101.69 of the Texas Alcoholic Beverage Code is as follows: “…a person who makes a false statement or false
representation in an application for a permit or license or in a statement, report, or other instrument to be filed with the Commission and
required to be sworn commits an offense punishable by imprisonment in the Texas Department of Criminal Justice for not less than 2 nor
IMPORTANT
more than 10 years.”
If Applicant is:
Who Must Sign:
Individual
Partnership
Corporation
Limited Partnership
Limited Liability Partnership
Individual Owner
Partner
Officer
General Partner
General Partner
Limited Liability Company
Officer or Manager
ACKNOWLEDGMENT
PRINT NAME
HERE
APPLICANT: PRINT NAME
SIGN
HERE
APPLICANT: SIGN NAME AS SHOWN ABOVE
Before me, the undersigned authority, on this
day of
, 20
the person whose
name is signed to the foregoing application personally appeared and, duly sworn by me, states under oath that he or she has read the said
application and that all the facts therein set forth are true and correct.
SEAL
SIGN
HERE
NOTARY PUBLIC
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Form MB (08/2015)
ALL RENEWAL INSTRUCTIONS
RENEW online at https://online.tabc.texas.gov and login to your existing account or click
the “Registration” link. Payments can be made by credit card or electronic transfer (ACH). Do
not submit application by mail if you renew online.
RENEW by mail: Verify information shown in 1 through 5 for accuracy.
Tradename and mailing address changes can be made directly on this form by marking through the
incorrect information and entering the current information. Any other changes will require additional
forms. Contact your local TABC office or the Licensing Division at 512-206-3360.
Sign this application before a notary public. Retain a copy of this renewal for your records.
STATE FEES AND SURCHARGES are printed on the front page. Please add your fees and
surcharges together for the total amount due.
PAYMENTS: Must be paid with a cashier's check, money order or company check payable to the
Comptroller of Public Accounts. Personal checks will not be accepted. The postmark date will serve
as proof of timely filing.
MAIL your renewal, bond if required, and total amount due to:
TABC
PO Box 13127
Austin TX 78711-3127
NOTE: Bonds may only be required for retail and manufacturer licenses/permits.
LATE FILINGS: If you do not file this application before your expiration date, your license/permit will
expire and you must cease operations.
Your renewal may be filed within 30 calendar days after your expiration date. A $100 late fee will be
required for each license/permit, in addition to all fees and surcharges.
OTHER FEES: Please note additional fees may be due to your city/county. It is your responsibility to
contact these authorities to determine what amounts, if any, may be due and pay those fees. Failure
to pay fees due to the city/county may result in administrative action against your license/permit by
the commission.
For forms and additional information visit us at: www.tabc.texas.gov
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Form MB (08/2015)