Liquor License Application July 1, 2020 to June 30, 2021

2. Now Accepting Credit Cards!!
   Use the link on the submission confirmation page after you hit submit to pay with a credit card.
4. City of Delafield Liquor License Application
   Please fill out the entire form before submitting. Any incomplete applications will receive an email denial with reason. The license iteself cannot be completed until the police have completed their background check, the Common Council has approved the license, and the payment has been made. Note: if there are any outstanding invoices due to the City or the County, you may not be approved until those invoices are paid in full. Complete payment should be mailed to the Clerk's office at 500 Genesee St. Delafield, WI 53018. TO PAY BY CREDIT CARD, USE THE LINK ON THE SUBMISSION CONFIRMATION PAGE.
6. This Liquor License is for...*
8. And we are applying for a...*

   1. Class "A" Beer ($100.00)
   2. Class "B" Beer ($100.00)
   3. "Class C" Wine ($100.00)
   4. Cigarette ($100.00)
   5. "Class A" Liquor ($500.00)

   1. "Class B" Liquor ($500.00)
   2. Reserve Class "B" Liquor* ($500.00)
   3. Entity Exchange ($30.00)
   4. Class "B" Winery
   5. Class "A" Cider

   There is a publication fee of $20.00 for every application.
9. Disclaimer
   The City would like to collect the payment for your license in full at the time of the application. We understand we cannot make that a condition of your license. It does however speed up the process by which you receive your license.
11. NO REMINDER PHONE CALLS WILL BE MADE. IF YOU ARE NOT ABLE TO MAKE YOUR PAYMENT ON TIME, YOU MAY FORFEIT YOUR LICENSE TO ANOTHER. Licenses are on a first come, first served basis.
13. State Forms
    Below are links to the required State Forms. You must print off the most recent version (linked), fill them out, sign them, and upload them into this space. You do not need to upload individually. A copy of your sellers permit is also required.
15. DOR Forms Page
    https://www.revenue.wi.gov/Pages/Form/alcohol-Home.aspx
16. *You must include your Sellers Permit Number and your EIN
18. Make Sure You Upload Everything*

    1. Original (AT-106) or Renewal (AT-115) Application
    2. Agent Appointment (AT-104) - only if changing agents from last year
    3. Aux Questionnaire (AT-103)
    4. Seller's Permit (most recent)

    Note: the forms from the DOR DO NOT SAVE with your filled items. You must print and scan. If you save and upload, we get a blank form and will email you to do it again.
19. Upload*
21. If you need another upload, use this space.
22. If you need another upload, use this space.
24. Agent Appointment*

    1. My agent is the same as last year. (you do not have to fill out a new form)
    2. I have a new agent and will submit the form.
26. If you are also applying for a Cigarette License, please upload as part of your liquor application. Fee: $100.00
27. DOR Link Cig App
    https://www.revenue.wi.gov/dorforms/
29. Liquor License Premise Description
31. Our liquor will be stored...*
    What you list will appear on your license.
33. Our liquor will be sold...*
    What you list will appear on your license. This must confirm with what you have listed on your Business Plan of Operation with the City.
34. If you have special events, please include the name of the event or the date if you wish to have it be included in your description.
    Example: Delafield Night Out 2020 on the patio, Art Walk 2020 in the parking lot.
36. Our invoices will be located...*
    What you list will appear on your license.
38. Wholesaler Contact Information
40. If you have more than 5 wholesalers, please upload a list that includes the name, contact, and phone.
41. This item is required either as an upload or individual list.
43. Company Name
44. Contact Name
45. Contact Phone
46. Contact Email
48. Company Name
49. Contact Name
50. Contact Phone
51. Contact Email
53. Company Name
54. Contact Name
55. Contact Phone
56. Contact Email
58. Company Name
59. Contact Name
60. Contact Phone
61. Contact Email
63. Company Name
64. Contact Name
65. Contact Phone
66. Contact Email
68. Licensed Operators List
    Please include a list of current licensed operators for your business. If you have more than 12, please upload a list in the space below.
85. Licensed Operator List Upload (if needed)
86. This item is required either as an upload or individual list.
90. ACKNOWLEDGEMENT
    By submitting this document, you acknowledge the following: I understand I must pay the license fee in full if I wish to have a liquor license assigned to my business. I understand I can have no outstanding bills with the City of Delafield and possibly Waukesha County. I understand the agent information is sent to the Police Department for a background check, a legal notice for the license is placed in the paper, and the Common Council must approve the license application before the Clerk can send me my license. I understand if I hold a reserve license, my license does not come with me if I move my business to another location. I understand I cannot sell my liquor license to someone else; they have to apply through the City and I either relinquish my license within the year or when I do not pay for my license the following year, it will revert back to the City.
92. I would like the license emailed to...*
93. The parent company would also like a license emailed to...
95. Contact Name*
96. Contact Phone*
98. No paper licenses will be mailed out except upon written request. Licenses must be displayed and be visible from the point of sale.
    If you have a business with a drive up service, please include your outside drive up in your premise description. Note: if you have not already changed your business plan of operation to include the drive up portion as part of your business, you may be operating illegally. Check with the City Planner if you are unsure.
Leave This Blank:


100. 1. Receive an email copy of this form.
101. Email address

     This field is not part of the form submission.

102. Submit

* indicates a required field