(1204) Liquor Sales Licence Renewal/Reinstatement Application

Alcohol and Gaming Commission of Ontario
Licensing and Registration
90 SHEPPARD AVE E
SUITE 200
TORONTO ON M2N 0A4
Tel: 416 326-8700
Toll free in Ontario: 1 800 522-2876
Fax: 416 326-5555
Website: www.agco.on.ca
Liquor Sales Licence
Renewal/Reinstatement
Application
This document contains the following:
Page
INSTRUCTIONS

2
CHECKLISTS
Renewal Licence

Reinstatement of Licence
APPLICATION
1204E (2013/04)


© Queen’s Printer for Ontario, 2013
3-4
5
Disponible en français
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Page 1 of 8
INSTRUCTIONS
The checklists indicate the documents that must
be submitted for your application to be processed
by the AGCO.
Incomplete applications are returned to the
applicant with a list of the incomplete and/or
outstanding documents.
Attachments
Where the space provided is insufficient to
complete your response, use a separate sheet of
paper and mark the question number at the top
of the page.
Do not fax application forms or personal history
reports. Do not mail photocopies of these
documents. Original, ink signatures are required.
Warning
If the AGCO requires more information, you will
be contacted.
Do not misrepresent or omit any material fact(s).
Each statement made in this application is subject
to verification.
Responses
It is a serious offence to knowingly provide false
information on the forms and on any attachments.
Complete all questions on all applicable forms. If
a question does not apply to you, respond by
marking “N/A”.
All application forms must be completed in ink.
Do not use pencil.
Contact Information
Contact AGCO Customer Service at 1 800 5222876 or 416 326-8700 if you have any questions.
Application forms and guides are available from
our website at: www.agco.on.ca
The provision of false, incomplete, or misleading
information or the omission of information on the
forms or in the documents submitted with your
application, or the failure to notify the Alcohol and
Gaming Commission of Ontario of any material
changes to this information which occur after this
application is filed, may also result in the refusal,
suspension or revocation of your liquor licence.
Mail or deliver your complete
application to:
ALCOHOL & GAMING COMMISSION
OF ONTARIO
LICENSING AND REGISTRATION
90 SHEPPARD AVE E
SUITE 200
TORONTO ON M2N 0A4
INCOMPLETE APPLICATIONS WILL BE RETURNED TO THE APPLICANT.
1204E (2013/04)
Page 2 of 8
HECKLIST for Renewal Application
C
You must submit all of the required fees, forms and documents, or your application will be returned to
you.
The following items must be submitted for your application to be processed:

Application Fee
The application fee is listed on the attached “Fee Schedule”. Application fees can be paid by:

cheque payable to "Minister of Finance". Post-dated cheques are not acceptable.

money order payable to "Minister of Finance".

Visa, Mastercard or American Express. Complete the enclosed Credit Card Payment form.

If you are enclosing an application for a golf course endorsement please include
the appropriate fee.
All fees are non-refundable.
Licence number and/or establishment name must be clearly legible on cheque, money
order or credit card slip.

Application Form

all questions must be answered; if a question does not apply, print "N/A"

must be signed and dated by the applicant(s)

Establishment Description Form

all questions must be answered

Business Name Registration

The business name under which you operate must be registered with the Ministry of
Government Services (MGS).
For information regarding business name registration please contact MGS toll free at
1 800 361-3223 or visit the website at: http://www.serviceontario.ca
INCOMPLETE APPLICATIONS WILL BE RETURNED TO THE APPLICANT.
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Page 3 of 8
Important Information for Renewal Application

Retail Sales Tax
Your liquor sales licence renewal application will not be accepted if the licence holder
owes money to the Minister of Finance (retail sales tax).
It is your responsibility to contact the Minister of Finance at 1 866 668-8297 to determine
if you owe any money.
If you submit your liquor sales licence renewal application, and the licence holder owes
money to the Minister of Finance, your application will not be accepted, it will be
returned to you.

Change of Ownership
Your liquor sales licence renewal application will not be accepted if there has been a
change of ownership that has not been previously reported to the AGCO.
If there has been a change of ownership, you must submit a liquor sales licence transfer
application to the AGCO.

Expiry Date
Your liquor sales licence renewal application must be received by the AGCO on or before
the expiry date on your liquor licence.
If your renewal application is not received by the expiry date on your liquor licence, your
licence will expire and you can no longer sell or serve alcohol.
EXPIRED LIQUOR LICENCES CANNOT BE RENEWED.
If your liquor sales licence has expired, you may apply to reinstate your licence. Please
refer to the enclosed Reinstatement Application on page 16.
YOU ARE PROHIBITED, UNDER SECTION 5(1) OF THE LIQUOR LICENCE ACT,
R.S.O. 1990 c. L.19, FROM SELLING/SERVING ALCOHOL WITHOUT A VALID
LIQUOR LICENCE.
1204E (2013/04)
Page 4 of 8
C
HECKLIST for Reinstatement Application
You may apply to reinstate your liquor sales licence if:
1.
2.
3.
4.
The ownership of the establishment has not changed; and
The establishment has been licensed within the past six months; and
The boundaries of the licensed areas have not changed; and
The capacity of the establishment has not changed.
Upon review of your application, if additional information is required we will contact you.
The following items must be submitted for your application to be processed:

Application Fee
The application fee is listed on the attached “Fee Schedule”. Application fees can be paid by:

cheque payable to "Minister of Finance". Post-dated cheques are not acceptable.

money order payable to "Minister of Finance".

Visa, Mastercard or American Express. Complete the enclosed Credit Card Payment form.

If you are enclosing an application for a golf course endorsement please include
the appropriate fee.
All fees are non-refundable.
Licence number and/or establishment name must be clearly legible on cheque, money
order or credit card slip.

Application Form

all questions must be answered; if a question does not apply, print “N/A”

must be signed and dated by the applicant(s)

Establishment Description Form

all questions must be answered

Business Name Registration

The business name under which you operate must be registered with the Ministry of
Government Services (MGS).
For information regarding business name registration please contact MGS toll free at
1 800 361-3223 or visit the website at: http://www.serviceontario.ca
INCOMPLETE APPLICATIONS WILL BE RETURNED TO THE APPLICANT.
1204E (2013/04)
Page 5 of 8
Alcohol and Gaming
Commission des alcools
Commission of Ontario
et des jeux de l’Ontario
Licensing and Registration
Inscription et délivrance des permis
90 SHEPPARD AVE E
90 AV SHEPPARD E
SUITE 200
BUREAU 200
TORONTO ON M2N 0A4
TORONTO ON M2N 0A4
Tel./Téléphone : 416 326-8700
1 800 522-2876 toll free in Ontario/sans frais en Ontario
Fax/Téléc. : 416 326-5555
Website/Site Web : www.agco.on.ca
1.
Liquor Sales Licence Renewal/
Reinstatement Application
Demande de renouvellement
ou de remise en vigueur d'un
permis de vente d'alcool
Preferred Language / Langue préférée
Type of Application / Genre de demande
 English
 Français
I am applying for: / Genre de demande :


2.
Renewal / Renouvellement
Expiry date of liquor licence /
Date d'expiration du permis
de vente d'alcool
Reinstatement / Remise en vigueur
YY/AA
MM
DD/JJ
Establishment Information / Renseignements sur l’établissement
Establishment name / Nom de l’établissement
Liquor licence Number /
No de permis d’alcool
Exact Address of Establishment (not mailing address) / Emplacement exact de l’établissement
(pas l’adresse postale)
Tel. No. / No de téléphone
Unit Number / Unité
City, Town or Village / Ville ou village
(
Postal Code / Code postal
)
—
Fax No / No de télécopieur
(
)
—
Mailing Address of establishment (if different from above) / Adresse postale de l’établissement (si différente de celle indiquée ci-dessus)
Street number /
Numéro
Street name / Nom de rue
Street type /
Genre de rue
Suite, Floor, Apt. Lot, Concession, Rural Route
Bureau/étage/App.
3.
City, Town Municipality / Ville, village, municipalité
Direction /
Orientation de rue
Postal Code / Code postal
Contact Person (for processing this application) /
Renseignements sur la personne-ressource (en vue du traitement de la demande)
Name / Nom
Email Address / Courriel
Street number /
Numéro
Street name / Nom de rue
Street type /
Genre de rue
Suite, Floor, Apt.
Lot, Concession, Rural Route
Bureau/étage/App.
City, Town Municipality / Ville, village, municipalité
Direction /
Orientation de rue
Postal Code / Code postal
Telephone No.(Home) / No de téléphone (domicile)
Telephone No. (Work) / No de téléphone (travail)
Fax No. / No de télécopieur
(
(
(
)
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4.
Has the establishment name changed? / Le nom de l’établissement a-t-il changé?
If YES, the new name is: / Si OUI, le nouveau nom est :
5.
Have the boundaries of the licensed areas changed since the last time the liquor sales licence was issued
(not including cosmetic changes such as redecorating or painting)? / Les limites de la zone pourvue du
permis ont-elles changé depuis la dernière fois que le permis de vente d’alcool a été délivré (sans tenir
compte des changements esthétiques tels que la décoration ou la peinture)?
If YES, please provide details. / Dans l’affirmative, fournir des détails.
You may be required to submit an Application for Changes or Additions to Licensed Areas – Form # 1221 /
Vous devrez peut-être fournir le formulaire 1221, Demande de modifications aux zones pourvues d'un
permis ou d'ajout à ces zones, dûment rempli.
6.
Have you or any individual involved in the licence been charged or convicted of any offences in any
jurisdiction within the previous four years? You must include any absolute and conditional discharges
and any outstanding charges. / Avez-vous déjà été, vous ou toute personne liée au permis, accusé ou
reconnu coupable d'une infraction dans quelque territoire que ce soit au cours des quatre dernières
années? Veuillez inclure une libération conditionnelle, une libération inconditionnelle ou des
accusations en instance.

Yes /
Oui
Yes /
 Oui
Yes /
 Oui

No /
Non

No /
Non

No /
Non

No /
Non

No /
Non

No /
Non
If YES, complete and submit a Personal History Report – Form # 2075 / Dans l’affirmative, veuillez fournir le formulaire 2075,
Renseignements personnels, dûment rempli.
7.
Who will manage the day-to-day operation of the liquor business at this establishment? /
Qui gérera les activités quotidiennes de l’établissement?

Self /
Mois-même

Other (Please specify) /
Autre (veuillez préciser)
Must complete and submit a Personal History Report Form 2075 /
doit fournir le formulaire 2075, Renseignements personnels, dûment rempli.
8.
Have there been any changes, additions and/or deletions to officers and/or directors of the corporation? /
Y a-t-il eu des changements, des ajouts ou des retraits quant aux dirigeants ou administrateurs de la société?
If YES, complete and submit a Corporate Structure Form # 2071 / Dans l’affirmative, veuillez fournir le formulaire 2071, Structure
organisationnelle, dûment rempli.
New officers and/or directors must also submit a Personal History Report. / Les nouveaux dirigeants ou
administrateurs doivent aussi fournir le formulaire Renseignements personnels dûment rempli.
9.
Have there been any changes, additions and/or deletions to the shareholders of the corporation? /
Y a-t-il eu des changements, des ajouts ou des retraits quant aux actionnaires de la société?
If YES, complete and submit a Corporate Structure Form # 2071 / Dans l’affirmative, veuillez fournir le formulaire Structure
organisationnelle dûment rempli.
NOTE: A Liquor Sales Licence Transfer Application - Form # 1203B will be required for the addition of
shareholders with 10% or more shares / REMARQUE : Les nouveaux actionnaires détenant 10 % ou plus
des actions doivent fournir le formulaire 1203B, Demande de cession de permis de vente d'alcool, dûment
rempli.
10.
Will any person and/or organization other than those involved in the ownership receive 15% or more of
the profits related to the sale of liquor? / Est-ce qu’une personne ou une organisation autre que celles
qui sont en cause dans la propriété recevront 15 % ou plus des profits réalisés grâce à la vente
d’alcool?
If YES, attach a copy of the management agreement. / Dans l’affirmative, veuillez joindre une copie de l’entente de gestion.
1204 (2013/04)
Yes /
 Oui
Yes /
 Oui
Yes /
 Oui
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11.
Applicant Signature / Signature de l’auteure ou auteur ou des auteurs de la
demande
If the applicant is a sole proprietor, he/she must sign below.
If the applicant is a corporation, a person with authority to bind the corporation must sign below.
If the applicant is a partnership, all partners must sign below.
La demande doit être signée ci-dessous par la ou le propriétaire de l’entreprise lorsqu’il s’agit d’une
entreprise personnelle.
La demande doit être signée ci-dessous par une personne habilitée à engager l’entreprise lorsqu’il s’agit
d’une personne morale.
La demande doit être signée ci-dessous par tous les associés lorsqu’il s’agit d’une société en nom collectif.
By signing this form I/we solemnly declare that all information provided in this application is true and correct. /
En signant cette formule, je déclare (nous déclarons) solennellement que les renseignements fournis sont fidèles et exacts.
Print name / Nom en lettres moulées
Signature
Date
Print name / Nom en lettres moulées
Signature
Date
Print name / Nom en lettres moulées
Signature
Date
Notification
The above information is collected pursuant to the Liquor Licence Act, R.S.O. 1990, c. L.19, as amended. The
principal purpose of the collection is to determine eligibility for the issuance of a liquor sales licence. The
information may also be disclosed pursuant to the Freedom of Information and Protection of Privacy Act, R.S.O.
1990, c. F.31. For questions about the collection of this information, please contact the Manager, Liquor Licensing,
Alcohol and Gaming Commission of Ontario, 90 SHEPPARD AVE E, SUITE 200, TORONTO ON M2N 0A4,
telephone 416 326-8700, toll free in Ontario 1 800 522-2876. Email address: [email protected]
Avis
Les renseignements fournis dans la présente formule sont recueillis aux termes de la Loi sur les permis d’alcool,
L.R.O. 1990, chap. L.19, telle que modifiée, dans le but premier de déterminer l’admissibilité à un permis de vente
d’alcool. Ces renseignements peuvent également être divulgués aux termes de la Loi sur l’accès à l’information et la
protection de la vie privée, L.R.O. 1990, chap. F.31. Les questions relatives à la collecte de renseignements doivent
être adressées à la ou au chef du Service de délivrance des permis d’alcool et de circonstance, Commission des
alcools et des jeux de l’Ontario, 90 AV SHEPPARD E, BUREAU 200, TORONTO ON M2N 0A4. Tél. : 416 326-8700
ou 1 800 522-2876 (interurbains sans frais en Ontario). Courriel : [email protected]
Clear Form Entries / Effacer des entrées de la Formule
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