FORMS

Form Description
Agency Application – DLC0001 This form is used to apply to become a Contract Liquor Agency. Before applying, it is recommended that you view our "Online Services" area and click on "Available Liquor Agencies" to see if there are any available. In addition, it may be helpful to go under our "How Do I..." area and click on How Do I "Qualify to Become a Liquor Agency".
Agency Contract - Combo (Sample Only) – DLC0005 This is a sample of what a typical Wholesale Agency Contract would look like.
Agency Contract - Retail (Sample Only) – DLC0004 This is a sample of what a typical Retail Agency Contract would look like.
Agency Proforma Profit & Loss Statement – DLC0003 This form is used to calculate projected first (1st) year profit and loss for Liquor Agencies.
Agency Transfer Request –DLC8047 This form is used when a permit holder wants to transfer where they are assigned to purchase their wholesale liquor.
Limited Liability Company Disclosure Form – DLC4032 This form is used by Limited Liability Companies to disclose members with 5% or more membership or voting interest, all managing members, and officers.
Officer/Shareholders Disclosure Form – DLC4030 This form is used by corporations to disclose officers and shareholders of a corporation.
Ohio Liquor Agency Qualifications & Requirements This publication will explain to you the procedure, qualifications, selection process and contract highlights for becoming a State of Ohio Liquor Agency.
Partnership Disclosure Form – DLC4031 This form is used by partners of a partnership to disclose information necessary to process their agency application.
Personal History Background Form – DLC4121 Section A only of this form must be completed for each individual for whom a background check will be performed by the Ohio Bureau of Identification and Investigation (“BCI&I”). The Division of Liquor Control will submit this form to the local authorities to conduct a background check and at that time Section B will be completed. The applicant is NOT to perform this check, therefore do not take this form to your local police authority.
Store Layout Diagram Checklist - DLC002 This form is used as a checklist for store shelving layout in a liquor agency.

Form Description
Certificate of Registration – DLC1551 This form is used for companies that wish to sell spirits (greater than 42 proof) in Ohio. If applicable, please use the checkbox for S-3 registration.
Listing Manual The first step in selling spirituous liquor products greater than 42 proof (over 21% alcohol) in Ohio is to present it to the Division of Liquor Control in the form of a listing presentation. The listing presentation, policies, guidelines and related documents can be found in the Listing Manual.
Listing Presentation Form This form is used to gather information regarding your company’s sales and promotional plans for a proposed liquor brand. In addition, it is helpful to supply sales data from other states (if applicable) and any other market testing or research information which would justify listing the item for sale in Ohio.
W-9 Form As a vendor doing business with the State of Ohio, the Internal Revenue Service requires that the State of Ohio maintain accurate tax identification information for all vendors that receive payments from the state. Therefore, complete this form and return it to the Division to make certain that the name, address, business type, and federal tax ID number (TIN) matches IRS records.
Authorization Agreement for Direct Deposit of Warrants – OBM 1234 As a vendor doing business with the State of Ohio, this form is required to sign up for Electronic Funds Transfer (EFT) as the preferred method of payment.
Vendor Information Form This form is required for all new State of Ohio Vendors in order to assure an accurate, up-to-date record of vendor information. Information contained on form W-9 must match that provided on the Vendor Information Form. You should also use this form to report any changes in vendor information in order to maintain the State of Ohio system. This would include such items as change of name, change of address, or an additional address.
Standard Quotation and Specification Form This form is used by spirituous liquor suppliers (defined as greater than 42 proof or greater than 21% alcohol) to quote case prices to Ohio. The dollar amount shown as Total Invoice Cost is the amount that the Division of Liquor Control pays for the purchase of a case from the supplier. This amount is used as the base from which the Division calculates the shelf price to the consumer.

Form Description
S Permit Holder Shipment of Wine Reporting Form - DLC4231 This form is used by S permit holders to annually report the shipment of wine to Ohio Consumers electronically to the Division.

Form Description
Supplier Application for Manufacturers/Suppliers – DLC1551 This form is used to file the class S-1 (Beer), S-3 (Spirituous), S-4 (Mixed Beverages), or S-5 (Wine) for the registration of a supplier or manufacturer to sell beer, wine, and mixed beverages to wholesale distributors. Wine manufacturers who apply for a B-2A permit must also complete this registration. In addition, forms DLC1511 (Product/Label Registration) and DLC1539 (Territory Designation) must be completed with this application.
Product/Label Registration for Manufacturers/Suppliers – DLC1511 This form is for the registration of products to be sold by a manufacturer or out-of-state supplier. If applicable, form DLC1539 (Territory Designation) must be completed if using a wholesale distributor, and, if a new company, DLC1551 (Supplier Registration) must be completed with this application.
Product Territory Designation – DLC1539 This form is for the designation of a wholesale distributor along with the exclusive sales territory for products registered by a manufacturer or out-of-state supplier. If you wish you may view a list of the licensed wholesale distributors in Ohio.
S Permit – DLC1614 This form is used if you are a wine manufacturer, a brand owner or United States importer of wine, or the designated agent of a brand owner or importer of wine to sell wine directly to consumers via the mail. A manufacturer of wine must be entitled to a tax credit under 27 C.F.R. 24.278 and produce less than two hundred fifty thousand gallons of wine per year. In addition, forms DLC1511 (Product/Label Registration) and DLC1551 (Supplier Registration) must be completed with this application.
B-2A Permits – DLC1615 This form is used if you are a wine manufacturer, brand owner or United States importer of wine, or the designated agent of a brand owner or importer of wine to sell wine to retail permit holders. A manufacturer of wine must be entitled to a tax credit under 27 C.F.R. 24.278 and produce less than two hundred fifty thousand gallons of wine per year. In addition, forms DLC1511 (Product/Label Registration) and DLC1551 (Supplier Registration) must be completed with this application.
Manufacturer, Brewpub, or Warehouse – DLC4174 This form is used to file for the class A-1, A-1A, A-2, A-3, A-3A, A-4, B-2A, S, or W (with option for D6 Sunday Sale). To determine the definition of these and other classes, please go to http://www.com.ohio.gov/liqr/PermitClasses.aspx under Online Services. See above under "Licensing General/Company Specific Documents to be Filed" to determine the correct forms that must accompany this application.
B Distributor Permits – DLC4176 This form is used to apply for class B-1, B-2, B-3, B-4, or B-5 (distributor) Permits. To determine the definitions of these and other classes, please view "Permit Types & Fees" under Online Services. See above under "Licensing General/Company Specific Documents to be Filed" to determine the correct forms that must accompany this application.
Tasting By A Manufacturer Or Distributor – DLC1536 Complete this application to apply for a Tasting permit by a Manufacturer or Wholesale Distributor for Beer/Wine/Low Proof Mixed Beverages and Spirituous Liquor.
Tasting By A Manufacturer Or Liquor Broker/Supplier – DLC1541 Complete this application to apply for Tasting permit by a Manufacturer or Liquor Broker/Supplier for Spirituous Liquor at a Contract Liquor Agency.

Form Description
Solicitor Registration – DLC1504 This form is used for the registration of individuals acting as agents, solicitors, or salespeople employed by a manufacturer, supplier, broker, or wholesale distributor of beer and intoxicating liquor.
Solicitor Renewal – DLC1608 This form is used for the renewal of your solicitor registration.

Form Description
All Permit Classes & Fees Refer to this list to learn the definitions of each class of permit for which you may apply, along with the required Application fee(s).
Background Check / Fingerprint Information –DLC4191 Explanation of the fingerprint background check requirements, as well as a listing of the authorized third party vendors you must use to get electronically web checked.
Cancellation Form – (Pending Application/Issued Permit) Complete this form to Cancel your pending New or Transfer Application OR Issued Permit.
Economic Development (TREX) – What is a TREX? This document explains what an Economic Development(TREX) Transfer is, and has links to all documents and forms relating to the TREX transaction.
Requirements For Physical Inspection – DLC4070 Refer to this form to determine the basic inspection requirements you must meet for your C or D Class permit prior to the inspection of your premises.

Form Description
Affiliation Agreement – DLC4255 Complete this form when filing a D5A Application to show that the liquor permit holder is affiliated with the hotel/motel.
Club Officers Statement – DLC4050 Complete this form when filing an application for a new D4 permit.

Form Description
Safekeeping or Temporary Closing Authority Application – DLC4214 Complete this application if your business has been closed or needs to be closed for more than 30 days. Please read the application carefully to determine which type of closing request you will qualify for.

Form Description
Request for Expansion/Diminution(reduction) Of Permit Premises Form – DLC4248 Complete this form if you wish to permanently expand or reduce your permit premises.

Form Description
Civilian Identification Card This form is only for those persons residing outside the State of Ohio, and is used to process a required background check through the Ohio Bureau of Criminal Identification and Investigation (“BCI&I”). The charge for this service by BCI&I is $22.00 per card. Please contact the Division at (614) 644-2360 to request a print card(s). You must include with each Civilian Identification Card a completed “Request for Exemption from Electronic Fingerprint Submission Requirement” form from the Ohio Attorney General’s Office. When completing this form, in order to determine the basis for your exemption please see the Attorney General’s Request for Exemption Information Sheet.
Financial Verification – DLC4096 This form is used to disclose information about any funds used for the purchase or "set up" of a business. Use this form when submitting a transfer of ownership, LLC membership, or corporate shareholder transfer or new application. Note: When submitting a new application, if the business has been operating for over one (1) year, then you do not need to submit this form.
Non Profit Entity Disclosure Form – DLC4029 This form is used if you are a non-profit business, a municipal corporation, or a non-profit educational institution. File this form with a Permit application for A, B, C, or D Class, (except the D4), Transfer of Ownership, Transfer of Location, Limited Liability Transfer, or Stock Transfer Application.
Officer/Shareholders Disclosure Form – DLC4030 This form is used by corporations to disclose officers and shareholders.
Partnership Disclosure Form – DLC4031 This form is used by partnerships to disclose partners.
Limited Liability Company Disclosure Form – DLC4032 This form is used by Limited Liability Companies (LLC) to disclose members with 5% or more membership or voting interest, managing members, and officers.
Personal History Background Form – DLC4121 Section A only of this form must be completed for each individual for whom a background check will be performed by the Ohio Bureau of Identification and Investigation (“BCI&I”). The Division of Liquor Control will submit this form to the local authorities to conduct a background check and at that time Section B will be completed. The applicant is NOT to perform this check, therefore do not take this form to your local police authority.
Summary of Purchase Agreement – DLC4243 This form is used in lieu of (instead of) a Purchase Agreement when filing a Transfer of Ownership Application.
Summary of Tenancy Rights – DLC4085 This form is used to apply for a New, LLC Managing Member change, Stock Transfer Consent, and/or Transfer of Ownership or Location application if the applicant does not own the property. This form indicates to the Division the real owner of the property, and gives the applicant permission to use the property.

Form Description
D-4 (Club) – DLC4171 This form is used if you are a club which has been in existence for three (3) years or more prior to the issuance of such permit to sell beer and any intoxicating liquor to its members only, in glass or container, for on-premises consumption where sold. See above under "Licensing – Applications Specific, Documents to be Filed" to determine the correct form(s) that must accompany this application.
D-5B (Enclosed Shopping Center) – DLC4137 This form is used if you are located within an enclosed shopping mall, meeting certain criteria, and desire to have spirituous liquor for on-premises consumption only, beer and wine for on-premises, or off-premises in original sealed containers, until 2:30 A.M. See above under "Licensing General/Company Specific Documents to be Filed" to determine the correct forms that must accompany this application.
D-7 (Resort Area Permit) – DLC4124 This form is used if you are located within a resort area and desire to have beer and intoxicating liquor by glass or container, for on-premises consumption only, until 2:30 A.M. during the resort season. See above under "Licensing General/Company Specific Documents to be Filed" to determine the correct forms that must accompany this application.
Duplicate Bar – DLC4258 This form is used if you have more than two (2) Fixed Bars/Counters.
E Permit (Airline, Railroad, Sleeping Car Co.,....) – DLC4079 This form is used if you are the owner or operator of any railroad, a sleeping car company operating dining cars, buffet cars, lounge cars, or similar equipment, or an airline providing charter or regularly scheduled aircraft transportation service with dining, buffet, club, lounge, or similar facilities, to sell beer or any intoxicating liquor.
G Permit (Drugstore w/Registered Pharmacist) – DLC4080 This form is used if you are the owner of a drugstore in charge of a registered pharmacist to obtain alcohol for medicinal, industrial, mechanical, chemical, or scientific purposes.
H Permit (Carrier by Rail or Motor Vehicle) – DLC4147 This form is used if you are a carrier by rail or a for hire motor carrier who also holds a license issued by the public utilities commission to transport beer, intoxicating liquor, and alcohol, or any of these, in this state or delivery or use in this state. Please note that if you pick up or deliver alcohol in the State of Ohio, then you are required to apply for an "H" permit. However, if you are just passing through the State of Ohio, then you are not required to file for any type of permit from the Ohio Division of Liquor Control.
I Permit (Wholesale Druggist, Etc.) – DLC4148 This form is used if you are a wholesale druggist to purchase alcohol from the holders of A-3 permits and to import alcohol into Ohio subject to such terms as are imposed by the Ohio Division of Liquor Control, to sell at wholesale to physicians, dentists, druggists, veterinary surgeons, manufacturers, hospitals, infirmaries, and medical or educational institutions using such alcohol for medicinal, mechanical, chemical, or scientific purposes, and to holders of G permits for nonbeverage purposes only.
NEW Permit with general instructions – DLC4113 & Accompanying Forms This form is used in order to file for class C1, C2, D1, D2, D3, D3A, D4A, D5, D5A, D5D, D5E, D5F, D5G, D5H, D5I, D5J, D5K, D5L, D5M, D6, and D8 permits. To determine the definition of these and other classes, please go to http://www.com.ohio.gov/liqr/PermitClasses.aspx under Online Services. Please read each form carefully to determine the correct forms that must accompany this application.

Form Description
Temporary Liquor Permit Laws and Rules Brochure explaining what Ohioians should know about Temporary liquor permits under Ohio liquor laws and rules.
F Permit – DLC4115 & Accompanying Forms (Beer Only) This form is used for any association of ten (10) or more persons, labor union, charitable organization, or an employer of ten (10) or more persons sponsoring a function for his/her employees to sell BEER ONLY.
F-1 Permit – DLC4145 (BYOB) This form is used for any nonprofit organization to allow such a nonprofit organization, its members and guests to bring beer, wine, and intoxicating liquor in its original package, flask, or other container into a convention facility for consumption therein ("BYOB", or "Bring Your Own Bottle"), lawfully.
F-2 Permit – DLC4138 & Accompanying Forms (Non-Profit) This form is used for a non-profit organization organized for a charitable, cultural, fraternal, or educational purpose, to sell beer, wine, mixed beverages, and spirituous liquor by the drink, at a place where the sale of beer, wine, mixed beverages, and spirituous liquor on that day is otherwise permitted by law.
F-3 Permit – DLC4189 (Industry Education) This form is used for a non-profit organization of more than 250 members, whose primary purpose is to support, promote, and educate members of the beer, wine, or mixed beverage industry. An F-3 permit allows the organization to bring beer, wine, or mixed beverages in its original packages or containers into a convention facility or hotel, not for sale, for consumption within the facility or hotel for a period not to exceed five (5) days.
F-4 Permit – DLC4200 (Ohio Wines) This form is used for an association or corporation organized not-for-profit in this State to conduct an event that includes introducing, showcasing, or promoting Ohio wines (only issued to certain associations).
F-5 Permit – DLC4256 (River Boat) This form is used for an owner or operator of a riverboat with a capacity of over fifty-five (55) persons, and which is not regularly docked in the State, and whose owner or operator has a written contract with a nonprofit organization for the riverboat to participate in a festival.
F-6 Permit – DLC4257 (Wine Charity) This form is used for a nonprofit organization that is exempt from federal income taxation under the Internal Revenue Code of 1986, 100 Stat. 2085, 26 U.S.C.A. 501(c)(3), as amended, to sell wine at an event organized and conducted by, and for the benefit of, the nonprofit organization.
F-7 Permit – DLC4268 (Golf Event) This form is used for a "nonprofit organization" meeting certain criteria, to sell beer, wine, mixed beverages, and spirituous liquor by the individual drink at a "qualified golf event" until 1 A.M. not to exceed eight days.
F-8 Permit – DLC1611 (Publicly Owned Property) This form is used for a not-for-profit organization that manages, for the benefit of the public and by contract with a political subdivision of this state, publicly owned property to sell beer or intoxicating liquor by the individual drink at specific events conducted on the publicly owned property and appurtenant streets, but only if, and then only at times at which, the sale of beer and intoxicating liquor on the premises is otherwise permitted by law.
F-9 Permit – DLC1612 (Special Park) This form is used for a nonprofit corporation that operates a park on property leased from a municipal corporation or a nonprofit corporation that provides or manages entertainment programming pursuant to an agreement with a nonprofit corporation that operates a park on property leased from a municipal corporation to sell beer or intoxicating liquor by the individual drink at specific events conducted within the park property and appurtenant streets, but only if , and only at times at which, the sales of beer and intoxicating liquor on the premises is otherwise permitted by law. Additionally, an F-9 permit may be issued only if the park property is located in Franklin County. An F-9 permit shall be effective for a period not to exceed nine months.

Form Description
Economic Development (TREX) – DLC4244 This form is used if there are no permits available in the taxing district in which you want to place your permit. In order to TREX transfer class(es) you must complete Section A of the TREX Application and have the City/Village or Township complete Section B of the Application. Also complete one of the following applications depending on the type of transaction you are doing: an Application to Transfer Ownership Only Packet (DLC 4120), Application for Transfer of Ownership & Location Packet (DLC 4120), or an Application to Transfer Location Only Packet (DLC 4118). Those packets can be found below.
LLC Membership Interests, Officer, or Managing Members Change – DLC4259 This form is used if there is a change in LLC membership interests, officers or managing members. See above under “Licensing General/Company Specific Documents to be Filed” to determine the correct forms that must accompany this application.
Stock Transfer – DLC4158 This form is used if there is a change of shareholders, the amount of shares they hold, or an addition of a new 5% shareholder in a corporation. See above under “Licensing General/Company Specific Documents to be Filed” to determine the correct forms that must accompany this application.
Transfer of Location – DLC4118 This form is used if you wish to transfer the location of your existing permit. See above under “Licensing General/Company Specific Documents to be Filed” to determine the correct forms that must accompany this application.
Transfer of Ownership and/or Ownership & Location, & Accompanying Forms This form is used if you desire to transfer the ownership, or ownership and location of your existing permit. See above under “Licensing General/Company Specific Documents to be Filed” to determine the correct forms that must accompany this application.