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Preview - Ohio Dlc4120 Form
For Questions call (614)
Office hours - 8:00 a.m. to 5:00 p.m.
Ohio Department of Commerce
Division of Liquor Control
6606 Tussing Road, P.O. Box 4005
Reynoldsburg, Ohio
http://www.com.ohio.gov/liqr
APPLICATION FOR TRANSFER OF OWNERSHIP OR OWNERSHIP & LOCATION OF ALL PERMIT CLASSES LISTED BELOW
CAUTION: ALLOW 10 TO 12 WEEKS FOR PROCESSING. RETURN TO ADDRESS ABOVE
A. Processing Fee of $100.00 made payable to the Division of Liquor Control
B. Application completed in its entirety, notarized and signed. Indicate "Buyer Name" as it appears on permit.
C. If Individual, list Social Security Number at the right. __________________________________.
D. If Partnership, you must submit a completed DLC Form 4031, along with a copy of the Partnership Agreement.
E. If Corporation, you must submit a completed DLC Form 4030.
F. If Limited Liability Company, you must submit a completed DLC Form 4032.
G. If Court Appointed Transfer - you must submit Court documents. (See page 4 for further details).
Please be advised that any social security numbers provided to the Division of Liquor Control in this application may be released to the Ohio Department of Public Safety, the Ohio Department of Taxation, the Ohio Attorney General, or to any other state or local law enforcement agency if the agency requests the social security number to conduct an investigation, implement an enforcement action, or collect taxes.
Seller (Individual, Corporation, Partnership or LLC) |
Buyer (Individual, Corporation, Partnership or LLC) |
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DBA (doing business as) |
DBA (doing business as) |
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Premises Address |
Premises Address |
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Township (if outside city limits) |
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Township (if outside city limits) |
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County: |
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County: |
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City & Zip Code |
City & Zip Code |
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Email: |
Email: |
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Mailing Address |
Mailing Address |
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Phone Number: |
Phone Number: |
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Attorney's Name & Address |
Attorney's Name & Address |
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Attorney's Telephone |
Seller's Permit Number |
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Attorney's Telephone Number: |
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Number: |
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SELECT Class(es) of Permit(s) Being Transferred: |
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A1 |
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A1A |
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A2 |
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A3 |
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A4 |
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B1 |
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B2 |
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B3 |
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B4 |
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B5 |
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C1 |
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C2 |
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C2X |
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D1 |
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D2 |
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D3 |
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D3A |
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D3X |
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D5 |
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D6 |
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D7 |
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OTHER ____________ |
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SELECT Type of Transaction:
SALE CONVERSION
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GIFT |
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MERGER |
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CORPORATE NAME CHANGE |
OTHER _______________________________
SELECT Type of Business:
INDIVIDUAL
PARTNERSHIP
CORPORATION
LLC
FOR DIVISION USE ONLY
Data Entry Initials: ________________ |
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Data Entry Action: |
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Comments/Notes: |
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RECEIPT NUMBER: |
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Violations: |
YES |
NO |
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If "YES", what type _______________ |
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TAXING |
FEE |
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DISTRICT |
CODE |
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Ren Status: |
ISSD |
PEND |
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Proc. Fee Pd: |
YES |
NO |
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SELLERS NUMBER |
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BCI Fee Amount Paid: |
$ __________ |
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BUYERS NUMBER |
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BUS. |
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TYPE |
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DLC4120 |
EOE/ADA SERVICE PROVIDER |
Page 1 FOR TTY USERS DIAL ORS |
REV. |
1.Do you or any partner, office holder, managing member, 5% stockholder or member, spouse, or other person involved in this permit hold or have any interest in another permit business?
If YES, Give permit number & address on the line provided ______________________________________
________________________________________________________________________________________
YES
NO
2a. Have you or any partner, office holder, managing member, 5% stockholder or member, spouse, or other person involved in this permit ever been convicted of a felony or misdemeanor, including any
If YES, attach a written explanation.
2b. If applicant is a sole proprietor or partnership, will spouse work on the permit premises?
If YES, indicate spouse's full name__________________________________________________
3.Have you or any partner, office holder, managing member, 5% stockholder or member, spouse, or other
person involved in this permit ever been refused a permit, denied a renewal, or had a permit revoked from another state, by this Division, or the Liquor Commission? If YES, attach a written explanation.
4.Does applicant own the real estate on which the proposed business will be located?
IF NO, return a completed signed and dated copy of your LEASE OR RENTAL CONTRACT OR Summary of Tenancy Rights (DLC4085).
YES
YES
YES
YES
NO
NO
NO NO
5. Will the applicant be the sole owner of the business and equipment? |
YES |
NO |
IF NO , and the fixtures or equipment are rented, submit signed and dated copy of rental agreement. |
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6.Will any person, partnership, LLC, or corporation, excluding banks, building and loan associations, or the seller have ANY financial interest (such as money, loans, installment contracts, property or other interest) or share in the profits in
your business or your property, real or personal? |
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YES |
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NO |
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If YES, attach a written explanation. NOTE: Ohio Revised Code Section 4303.293 provides a criminal penalty for |
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failure to answer this question completely and correctly. |
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7.If transferring C or D class permits, do you or any partner, office holder, managing member, member, stockholder, employee, spouse or any other person involved in this permit own any stock or have any interest in the business of a manufacturer or
wholesale distributor of alcoholic beverages? |
If YES, attach a written explanation. |
YES |
NO |
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8.If transferring A or B class permits, do you or any partner, office holder, managing member, member, stockholder, employee, spouse or any other person involved in this permit own any stock or have any interest in the business of a retail permit
holder? If YES , attach a written explanation. |
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YES |
NO |
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THE FOLLOWING MUST BE COMPLETED BY THE SELLER(S): |
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I, ______________________________________________________, hereby authorize the Division of Liquor Control to process this application |
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Print Name(s) |
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_____________________________________________________________________________________________________________________ |
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(Signature and Title) |
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_________________________________________ |
___________________________ _________ |
______________ ________________________ |
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(Residence Address) |
(City) |
(State) |
(Zip Code) |
(Area Code & Phone No.) |
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THE FOLLOWING MUST BE COMPLETED BY THE BUYER(S):
WARNING: Ohio Law provides that as a proposed buyer you could be liable as a successor of the permit holder's unpaid sales, use, and withholding tax liabilities. The Division of Liquor Control will be unable to transfer the permit until the tax and assessment matters are resolved to the satisfaction of the particular agency. The buyer should request that seller obtain a sales tax release certificate, by contacting the Ohio Department of Taxation, Sales and Use Tax Division, Release Unit. A Withholding Tax Release Certificate Request should be made by contacting the Ohio Department of Taxation, Withholding Tax Division, Business Billing Unit. Also, the current permit holder may still owe Unemployment Compensation payments. To discuss these possible liabilities, you should contact the Ohio Department of Job & Family Services.
DELIBERATE MISREPRESENTATION OF ANY OF THE INFORMATION ON THE APPLICATION CAN
RESULT IN THE DIVISION'S REFUSING TO APPROVE THIS APPLICATION.
_____________________________________________ ________________________________ |
_____________________ _______________ |
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(Signature of Individual, Partner, Officer, Managing Member, |
(Print Name) |
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(Title) |
(Date) |
or 5% or more Stockholder or Member) |
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_________________________________________ |
___________________________ _________ _______________ _______________________ |
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(Residence Address) |
(City) |
(State) |
(Zip Code) |
(Area Code & Phone No.) |
(To be completed by Notary Public)
Sworn to before me and subscribed in my presence this ______________day of _____________________________________, 20 _____________.
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_____________________ |
(Notary Public) |
(Notary Expiration) |
NOTE: ALL DOCUMENTS BECOME PART OF THE PERMIT FILE AND WILL NOT BE RETURNED |
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Page 2
IMPORTANT - PLEASE READ FIRST
Dear Applicant:
The Division of Liquor Control (“Division”) is eager to process your application. In order to process your application in a timely and efficient manner it will be necessary for you to file a complete package in accordance with the items listed on the “Application Required Documents” check off sheet. Please follow and complete this list as you gather the items necessary for your transaction. If your application is filed without all of the documents, the application will not be accepted and will be returned to you. It is our goal to provide you with the most efficient and courteous service while processing your application. Your assistance in providing us with a complete application will ensure prompt service. In order to minimize inquiries regarding the status of your application, the following is an outline of the process used in completing your application.
Once your application is received, provided all required documents are submitted, the following process begins:
1.The Division logs your application into a computerized system for processing.
2.The Division will send an Official Notice to the legislative authority of the municipality, city council, or township trustees and county commissioners of your application. Note: Any of these entities has the right to object to your application, provided that they do so within 30 days of that notification. The Division also sends a separate notice to the local law enforcement agency however they do not have a right to formally object to the issuance of your permit.
3.The Division works with the Ohio Bureau of Identification and Investigation (“BCI&I”) to have conducted a required background check on all persons involved in your business. In order for the Division and BCI&I to conduct this background check, you are required to provide the Division with the proper documentation/information so that a background check can be performed. Please see the enclosed Form DLC 4191 to determine whether you or persons involved in your business should submit a completed paper fingerprint card or be fingerprinted electronically via a “Web
Check” system.
4.The Division will send the Personal History Background Form(s) you provided to the law enforcement agency in the municipality or township of your permit premises in order to have a background check conducted with them.
5.A Division Compliance Officer will contact you to set up an appointment to conduct an initial physical inspection of your premises. At the time your inspection is completed our compliance officer will survey the area surrounding the proposed permit premises to determine if there are any institutions such as schools, churches, libraries, public playgrounds, or township parks within 500 feet. By law, any of these institutions within 500 feet of your premises can object to the issuance of your permit within 30 days of notification. If the business is not in operation or the premises did not meet all requirements at the initial inspection, a final inspection will need to be conducted at a later date. Please allow two weeks when notifying the Division for a final inspection.
6.The Division will work with your County Board of Elections to determine the wet/dry status of your proposed permit premises. Note: This information is not needed on applications for transfer of ownership.
7.Where required, the Food Service Operation or Food Establishment License must be in the exact name as the liquor permit applicant.
It is our goal to process your application in a timely and efficient manner. Many factors determine the
length of time it takes to complete the processing of your application. Your assistance in providing us with a completed application and necessary documents will help in accomplishing our goal.
Licensing Section
Page 3
REQUIRED DOCUMENTS FOR ACCEPTANCE OF A TRANSFER PERMIT APPLICATION
Please use the list below to check off 
all items as you complete them, to submit with the application packet
CAUTION: ALLOW 10 TO 12 WEEKS FOR PROCESSING.
FAILURE TO SUBMIT THE FOLLOWING DOCUMENTS MAY RESULT IN THE RETURN OF YOUR APPLICATION,
UNRECEIPTED, WITH THE POSSIBLE LOSS OF PRIORITY ON THE QUOTA LIST.
Application: |
Application must be completed in full, all questions answered, signed, and notarized. |
Application Processing Fee:
Background Check:
Personal History Background Form (DLC4121):
Lease or Tenancy Agreement:
$100.00 - Check made payable to Division of Liquor Control.
PLEASE READ "BACKGROUND CHECK INFORMATION" DLC4191
Section A. ONLY must be completed in full for each stockholder or officer for whom a
background check will be performed by the Ohio Bureau of Identification and Investigation (BCI&I).
Submit copy of signed and dated lease, tenacy agreement, or may submit
DLC Form 4085 "Summary of Tenancy Rights" completed in full.
REQUIRED DOCUMENTS TO BE FILED WITH COURT APPOINTED TRANSFERS
Certified copy of the Journal Entry from the Court approving the sale, OR a certified copy of the Journal Entry of Distribution in Kind, OR a certified copy of the FINAL ACCOUNT showing distribution of the assets.
REQUIRED DOCUMENTS TO BE FILED WITH INDIVIDUALS ONLY
See list above "Required for All Types of Entities". No other documents are needed, unless requested during processing.
Note: If you are terminating your partnership and transferring to yourself as an individual, a copy of the DISSOLUTION AGREEMENT or COURT ORDER ending the partnership will be required.
REQUIRED DOCUMENT TO BE FILED WITH NON PROFIT ENTITIES
4029 Form: To be filed with Governmental or Educational entities, or other
REQUIRED DOCUMENTS TO BE FILED WITH CORPORATIONS ONLY
4030 Form (Corporation): Form must be completed in full. List the top five officers, including social security numbers. Indicate all stock holders over 5% including social security numbers. Indicate total shares issued. Must be notarized.
Certificate of Good Standing From If not incorporated in the State of Ohio, submit a copy of CERTIFICATE OF AUTHORITY
the Secretary of State:TO DO BUSINESS IN OHIO, issued by the Ohio Secretary of State. If corporation is nonprofit, submit a Certificate of CONTINUED EXISTENCE from the Ohio Secretary of State. Ohio Secretary of State: (614)
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REQUIRED DOCUMENTS TO BE FILED WITH PARTNERSHIPS |
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4031 Form (Partnership): |
Form must be completed in full. Indicate all partners including social security and/or Tax ID numbers. |
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Limited Partnerships need only indicate general partners. Must be notarized. |
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Partnership Agreement (if general partnership): |
If name is different from and not including the names of all |
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partners. Must be dated within one year of the filing of this application. |
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Certificate of Fictitious Name from the Secretary of State: |
Ohio Secretary of State: (614) |
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www.sos.state.oh.us |
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REQUIRED DOCUMENTS TO BE FILED WITH LIMITED LIABILITY COMPANIES |
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4032 Form (LLC): |
Form must be completed in full, indicating all members with 5% or more membership or voting |
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interest, all managing members, and officers, if applicable, including social security numbers. Must be notarized.
Certificate of Organization from the Secretary of State: |
Ohio Secretary of State: (614) |
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www.sos.state.oh.us |
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Page 4
LIST OF DOCUMENTS THAT MAY BE SUBMITTED AND/OR REQUESTED
DURING THE PROCESS OF YOUR TRANSFER APPLICATION
1.Submit a completed DLC form 4243, Summary of Purchase Agreement, OR signed and dated copy of SALES CONTRACT, stating total amount paid for the business and enclose a list of assets. If a GIFT, send a signed and notarized GIFT AFFIDAVIT Classes of permits to be transferred must be indicated in these statements.
2.FINANCIAL VERIFICATION OF THE TRANSACTION. Please refer to Form DLC 4096, Financial Verification Worksheet for instructions.
3.Transfers to Executors or Administrators - NO FILING FEE REQUIRED
a)Send certified copy of court appointment, signed by the judge and bearing court
4.Transfers to Court Appointed Representatives
a)Certified copy of your COURT APPOINTMENT indicating whether you can operate, bearing signature of the judge, and the court time stamp.
CORPORATIONS:
1.If not incorporated in the State of Ohio, a copy of the CERTIFICATE OF AUTHORITY TO DO BUSINESS IN OHIO from the Ohio Secretary of State, (614)
2.Copy of MERGER AGREEMENT if the transaction is a merger, and a Sec. 1701.81 (D) Certificate of Merger from the Ohio Secretary of State or whatever state the merger occurred in.
ADDITIONAL INFORMATION:
1.A RENEWAL application must be filed, in the name of the PRESENT PERMIT HOLDER, at least fifteen (15) days before the current permit's expiration date. Renewal application must be filed and signed by current permit holder.
2.A sole proprietor and all partners in a PARTNERSHIP must be a U.S. citizen.
3.Issuance of permits is subject to the WET or DRY status of location.
4.Return the application, all fees, and all required documents to:
OHIO DEPARTMENT OF COMMERCE
DIVISION OF LIQUOR CONTROL 6606 TUSSING ROAD, P.O. BOX 4005 REYNOLDSBURG, OHIO
NOTE: |
DO NOT SEND THE PERMIT OR LIQUOR PURCHASE CARD AT THIS TIME. These documents will be requested by |
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the Licensing Section of the Division of Liquor Control when the transfer is ready to be issued. |
NOTE: If the seller of the permit business is a corporation, the seller must send a certified copy of the minutes of the stockholders meeting signed by the corporate secretary at which the sale of the permit business assets was approved by the affirmative vote of the holders of
Page 5
Document Properties
| Fact Name | Details |
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| Application Purpose | The Ohio DLC4120 form is used to apply for the transfer of ownership or the ownership and location of all liquor permit classes. This is essential for businesses looking to operate legally within Ohio's liquor control framework. |
| Processing Time | Applicants should allow 10 to 12 weeks for processing. This timeframe is crucial for planning any business transitions, as delays can impact operations. |
| Fees Required | A non-refundable processing fee of $100.00 is required, payable to the Division of Liquor Control. This fee must accompany the application to initiate the transfer process. |
| Governing Law | The application process for the DLC4120 form is governed by the Ohio Revised Code Section 4303.293, which outlines the legal requirements and penalties associated with liquor permit applications. |
Documents used along the form
The Ohio DLC4120 form is essential for the transfer of ownership or location of liquor permits in Ohio. Several other documents complement this form to ensure a smooth and compliant transaction. Below is a list of these documents, each serving a specific purpose in the application process.
- DLC Form 4031 (Partnership): This form is required for partnerships and must include details about all partners, including their social security or tax identification numbers. It needs to be notarized.
- DLC Form 4030 (Corporation): Corporations must submit this form, which lists the top five officers and stockholders owning over 5% of shares. It must also be notarized.
- DLC Form 4032 (Limited Liability Company): LLCs must complete this form, detailing all members with significant interest and managing members. Notarization is required.
- DLC Form 4085 (Summary of Tenancy Rights): This document outlines the rights of tenants and must be submitted if the applicant does not own the property where the business will operate.
- California Motorcycle Bill of Sale: This essential document establishes the transfer of ownership of a motorcycle in California and can be accessed at documentonline.org/blank-california-motorcycle-bill-of-sale/.
- DLC Form 4191 (Personal History Background Form): Required for background checks, this form must be completed for each individual involved in the business, including partners and stockholders.
- Lease or Rental Agreement: If the applicant does not own the property, a signed lease or rental agreement must be submitted to demonstrate tenancy rights.
- Sales Contract or Summary of Purchase Agreement: This document outlines the financial aspects of the sale and must indicate the total amount paid for the business and a list of assets.
- Certified Court Documents: If the transfer is court-appointed, certified copies of relevant court documents must be provided to validate the transaction.
- Financial Verification Worksheet (DLC Form 4096): This form verifies the financial aspects of the transaction and may be requested during the application process.
These documents collectively support the application process for the Ohio DLC4120 form. Ensuring that all required forms and documents are complete and accurate will facilitate a smoother review and approval process.
Guidelines on Filling in Ohio Dlc4120
Completing the Ohio DLC4120 form is an essential step for those looking to transfer ownership of a liquor permit. After you fill out the form, it will be submitted to the Ohio Department of Commerce, Division of Liquor Control. Processing may take between 10 to 12 weeks, so it's important to ensure that all sections are completed accurately to avoid delays.
- Begin by gathering all necessary documents, including your processing fee of $100 made payable to the Division of Liquor Control.
- Fill out the application in its entirety. Ensure that the "Buyer Name" matches the name on the permit.
- If the buyer is an individual, provide their Social Security Number in the designated space. If a partnership, complete and attach DLC Form 4031 along with the Partnership Agreement. For corporations, attach DLC Form 4030, and for Limited Liability Companies (LLCs), attach DLC Form 4032.
- If the transfer is court-appointed, include the required court documents.
- Provide the seller's and buyer's details, including DBA (doing business as) names, premises addresses, and contact information.
- Select the classes of permits being transferred from the provided list.
- Choose the type of transaction, such as sale, conversion, gift, merger, or corporate name change.
- Indicate the type of business (individual, partnership, corporation, or LLC).
- Answer all questions related to prior permits, convictions, and ownership of real estate. Attach written explanations where required.
- Sign and date the application. Ensure that the signature is from the appropriate party, such as an individual, partner, or corporate officer.
- Have the application notarized to validate the signatures.
- Submit the completed application along with all required documents and the processing fee to the address provided: Ohio Department of Commerce, Division of Liquor Control, 6606 Tussing Road, P.O. Box 4005, Reynoldsburg, Ohio 43068-9005.
Common mistakes
Filling out the Ohio DLC4120 form can be a complex process, and several common mistakes can lead to delays or even rejection of the application. One frequent error is failing to complete the application in its entirety. Each section must be filled out completely, and any omissions can result in the application being returned. It is crucial to provide all requested information, including the names and addresses of all parties involved.
Another common mistake involves improper notarization. Applicants must ensure that the application is signed and notarized correctly. This means that the notary must be present when the applicant signs the document. If the notarization is not done properly, it can invalidate the application.
Many applicants neglect to include the required processing fee. The Ohio Division of Liquor Control mandates a non-refundable fee of $100. This fee must accompany the application. Failing to include this payment can lead to immediate rejection, wasting time and resources.
Another area of concern is the failure to provide necessary supporting documents. Depending on the type of entity involved—individual, partnership, corporation, or LLC—specific forms must be submitted alongside the DLC4120. For instance, partnerships need to include a completed DLC Form 4031, while corporations must submit DLC Form 4030. Missing these documents can cause significant delays in processing.
Applicants often overlook the importance of providing accurate Social Security numbers. If an individual is applying, their Social Security number must be listed accurately. Inaccuracies can lead to complications during background checks or other verification processes.
In addition, applicants sometimes fail to indicate the correct type of transaction. The DLC4120 requires applicants to select the type of transaction, such as sale or merger. If this selection is missing or incorrect, it can lead to confusion and delays in processing.
Another mistake is not addressing potential tax liabilities. The application warns that buyers could be held responsible for the seller's unpaid taxes. It is advisable for buyers to ensure that sellers obtain a sales tax release certificate before proceeding. Ignoring this can lead to unexpected financial obligations.
Finally, applicants may not follow up on the status of their application. Understanding that processing can take 10 to 12 weeks is essential. However, if there are any issues, the Division may not reach out proactively. Applicants should monitor their application status to ensure all requirements have been met and to avoid unnecessary delays.
FAQ
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What is the Ohio DLC4120 form?
The Ohio DLC4120 form is an application used to transfer ownership or the location of liquor permits in Ohio. It is essential for individuals or entities wishing to buy or relocate a liquor permit and encompasses various permit classes.
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What are the processing fees associated with the DLC4120 form?
A processing fee of $100.00 is required when submitting the DLC4120 form. This fee is non-refundable and must be made payable to the Division of Liquor Control.
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How long does it take to process the application?
Applicants should allow 10 to 12 weeks for processing. This timeframe can vary based on the completeness of the application and any potential objections raised during the review process.
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What documents are required to complete the application?
To ensure a smooth application process, you need to submit the following:
- Completed and notarized application form.
- Processing fee payment.
- Background check documentation.
- Lease or tenancy agreement, if applicable.
- Additional forms specific to your business structure (e.g., DLC 4030 for corporations).
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What happens if the application is incomplete?
If the application is submitted without all required documents, it will be returned unprocessed. This could result in a loss of priority on the quota list, delaying the transfer of the permit.
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Who should I contact if I have questions about the form?
If you have questions or need assistance, you can contact the Ohio Department of Commerce, Division of Liquor Control at (614) 644-3156. Their office hours are from 8:00 a.m. to 5:00 p.m.
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What are the consequences of misrepresentation on the application?
Deliberate misrepresentation of any information on the application can lead to the refusal of your application by the Division. It is crucial to provide accurate and complete information.
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Are there any additional requirements for specific business structures?
Yes, different business structures have specific requirements. For instance:
- Partnerships must submit a completed DLC Form 4031 and a partnership agreement.
- Corporations need to provide a completed DLC Form 4030 and a Certificate of Good Standing.
- Limited Liability Companies (LLCs) must submit a completed DLC Form 4032.