***Business license is required before Alcohol license can be issued*** Agent Information. Location/Business Information

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Business Development Services 200 Cherry Street, Suite 202 Macon, Georgia 31201 Alcoholic Beverage License Change of Agent Application Liquor Packaged $2,500 Beer Packaged $600 Wine Packaged $500 Liquor/ Mixed Drinks $2,500 Beer C.O.P. $600 Wine C.O.P. $500 Liquor Wholesale $3,600 Beer Wholesale $1,000 Wine Wholesale $700 Liquor Manufacturer $2,700 Beer Manufacturer $1,800 Wine Manufacturer $1,400 Brewpub $1,700 Catering $500 (Matches Retail Licenses) ***Business license is required before Alcohol license can be issued*** $ Alcohol License Fee + $300 Application Fee = $ **If license is current and only change of Agent is needed, then the alcohol license fee is waived but the application fee is still required. ** Business Name: Corporation Name: Agent Information 1. Agent Must Submit Completed Application In Person 2. Agent must complete and sign the History Record Information Consent Form 3. Provide an Unexpired Identification Card Issued by Any U.S. State or United States government, bearing a current photograph of the applicant. 4. Agent Must be Fingerprinted once application & fees are Completed and Paid Location/Business Information 5. If NON-PROFIT entity Proof on Nonprofit Status Application Processed by: License #: Page 1

Macon-Bibb County Alcoholic Beverage License Application Instructions AGENT INFORMATION 1. All applications must name one person as the agent of the licensee, who shall be responsible for any matter relating to the licenses. Mailing any notice required under the law to the agent named, at the mailing address provided shall be deemed sufficient notice to a licensee. 2. Any person named as agent on this application must be employed and regularly scheduled to work at the licensed location a minimum of 30 hours per week; and must be an employee with directorial authority over the operations of the enterprise, including (1) authority to hire and fire staff or oversee the process for making personnel decisions; (2) responsibility to train staff or oversee staff training, and to enforce staff policy compliance requirements; (3) authority to set and revise local business policies and practices, or to oversee the implementation or revision of local business policies and practices; and (4) authority to purchase and receive alcoholic beverage inventory for the enterprise, or to oversee alcoholic beverage inventory purchasing; 3. Any person named as agent on this application shall be personally and independently responsible for ensuring that all statements submitted on any license application or renewal are true and correct, and for ensuring that all state and local laws governing the commercial manufacture, distribution, and sale of alcoholic beverages are followed. 4. If any licensee, or any employee or other person acting at the direction thereof, shall be cited or charged with any violation of the Macon-Bibb County Code of Ordinances relating to the commercial manufacture, distribution, or sale of alcoholic beverages, then the agent of such licensee may also be charged with the offense of serving as an agent of a licensee in violation of the same Code provision if the agent in question directed, aided, participated in, ratified, or had knowledge of the actions underlying said violation; or that the agent in question had knowledge of the commission of a prior, similar violation committed by the same person, licensed entity, or employee within the previous calendar year. 5. If an agent becomes unwilling or unable to serve as agent for any reason, the licensee has ten business days in which to appoint a new agent, and to provide in writing all information required of agents as part of an application for a new license. Licensees and applicants may appoint a new agent by filing a written notice with the Department of Business Development Services on an approved form. Until a new agent is appointed, the mailing of any notice to the most recent agent of record shall be sufficient notice to a licensee. The new agent must also be fingerprinted by the Bibb County Sheriff s Office and shall be responsible for paying any fees associated therewith. The failure to appoint a new agent within ten business days shall be grounds for revocation of your license. Page 2

FINGERPRINTING INFORMATION BIBB COUNTY SHERIFF S OFFICE CENTRAL RECORDS UNIT 111 THIRD STREET, 1 ST FL MACON, GA 31201 (478) 803-2809 1. The Agent must be fingerprinted in order to obtain an alcohol license: 2. One or more people are required to complete fingerprint background checks as part of this application process. Each person required to be fingerprinted must be fingerprinted by the Bibb County Sheriff s Office (Central Records Unit). This is done by appointment only. 3. Before scheduling an appointment, the applicant must submit the completed Alcohol Application with license fee and pay a $41.00 GCIC fee per person to the Business License Division for the background check. Each person to be fingerprinted is required to be present when submitting the Alcohol application to the Business License Division. Once submitted, call (478) 803-2809 to schedule an appointment. No walk-ins are allowed. The Sheriff s Office charges $20 per person for fingerprinting payable at the appointment. Page 3

ALCOHOL HANDLER S LICENSES 1. Effective April 1, 2019, Macon-Bibb County now requires certain individuals responsible for the service or sale of alcoholic beverages at retail to obtain an Alcohol Handler s License. This license ensures that individuals responsible for selling alcohol at retail, or overseeing the sale of alcohol at retail, are known to Macon-Bibb County, and are properly trained in the safe sales and service of alcoholic beverages. 2. On or after April 1, 2019, in order to obtain ANY license that includes the sale of beer, wine, or liquor, whether for consumption on premises or packaged to go, including brewpub, malt beverage taproom, or cocktail room licenses, the following people must possess valid Alcohol Handler s licenses: (A) Any person who holds a twenty-five percent or greater ownership interest, whether directly or through any number of legal entities, in the business to be licensed, except that this requirement does not apply to publicly traded companies; and (B) The agent, if any, designated on the alcohol license. 3. NOTE: Applicants may receive a license as long as all of the people listed above have alcohol handler s licenses. However, effective April 1, 2019, for businesses selling alcohol for consumption on premises, other than restaurants earning more than 50% of their revenue from food sales, all employees or independent contractors responsible for pouring, mixing, or opening alcoholic beverages; and every person responsible with supervising or managing those employees or independent contractors, MUST each have their own alcohol handler s licenses in order to work at the licensed business. Page 4

BUSINESS INFORMATION Corporate and Trade Name: Federal Tax ID #: State Tax ID #: Street Address: City: State: Zip Mailing Address: City: State: Zip: Local Business Phone #: AGENT INFORMATION Agent s Name: Agent s Title: Home Address: City: State: Zip: Home Phone #: Email: Date of Birth: Social Security Number: Mailing Address: City: State: Zip: Agent Certification The undersigned certify that the information contained in this application and accompanying documentation is true and correct, and that the Agent named herein has directorial authority over the operations of the business to be licensed. The undersigned further agree to abide by, observe, and conduct the licensed business according to all county ordinances and state laws and regulations in respect thereof, and understand that the Agent named herein may be held personally responsible for violations of County Alcohol Code committed by others at the Agent s direction, or with the Agent s knowledge. Agent s Signature: Date: Business Name: I hereby certify that (Agent) signed his/her name to the forgoing statement after stating to me under oath administered by me, that all statements and answers are true and correct. This day of, 20 NOTARY PUBLIC MY COMMISSION EXPIRES Page 5

Name-Based Criminal History Record Information Consent/Inquiry Form I hereby give consent for the Bibb County Sheriff s Office to conduct an inquiry and receive any Georgia criminal history record information pertaining to me, which may be contained in the files of any state or local criminal justice agency in Georgia. Full Name (print): Home Address: Sex Race Date of Birth Social Security Number This authorization is valid for 90/180/ (circle one) days from date of signature. I,, give consent to the above name to perform periodic criminal history background checks for the duration of my employment with this company. Signature Date ***Include a copy of your valid State/Government issued identification*** Date of Inquiry: Time of Inquiry: Operator s Initials: Purpose Code used: (check one) Employment (E) Provides Georgia Criminal History Record Information Employment with Mentally Disabled (M) Provides Georgia Criminal History Record Information Employment with Elder Care (N) - Provides Georgia Criminal History Record Information Employment with Children (W) - Provides Georgia Criminal History Record Information Public Records (P) Provides Georgia Felony Convictions Only The inquiry resulted in the following: (check all that apply) No Georgia CHRI results available. Georgia CHRI attached/released No NCIC/GCIC Warrant results available. Possible NCIC/GCIC Warrant. Contact Agency listed below. Wanting Agency Name: Agency Telephone: Agency Designee Signature and Title Date Page 6

MACON-BIBB COUNTY, GEORGIA (S.A.V.E.) SYSTEMATIC ALIEN VERIFICATION FOR ENTITLEMENTS O.C.G.A. 50-36-1 (e) (2) Affidavit By executing this affidavit under oath, as an Agent for a Macon-Bibb County, Georgia, Occupation Tax Certificate, Alcohol License, or other public benefit as referenced in O.C.G.A. 50-36-1; the undersigned Agent verifies one of the following with respect to my application for a public benefit: 1) I am a United States citizen. OR 2) I am a legal permanent resident of the United States. OR 3) I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act with an alien number issued by the Department of Homeland Security or other federal immigration agency. My alien number issued by the Department of Homeland Security or other federal immigration agency is. The undersigned Agent also hereby verifies that he or she is 18 years of age or older and has provided at least one secure and verifiable document, as required by O.C.G.A. 50-36-1 (e) (1), with this affidavit. The secure and verifiable document provided with this affidavit can best be classified as. 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 O.C.G.A. 16-10-20, and face criminal penalties as allowed by such criminal statute. I hereby declare under penalty of perjury that the foregoing is true and correct. Name of Business: Printed Name of Agent: Signature of Agent: Executed in, (City) (State) SUBSCRIBED AND SWORN BEFORE ME ON THIS DAY OF, 20 NOTARY PUBLIC MY COMMISSION EXPIRES We have in-house Notary service available for Business License documents only. Affidavits must be signed in the presence of the Notary with proper identification.