Department of Alcoholic Beverage Control State of CaliforniaARNOLD SCHWARZENEGGER, Governor
PERMIT FOR TEMPORARYCONTINUATION OF RETAIL BUSINESS
NAME OF PERSON ACTING ON BEHALF OF DECEASED OR IMCOMPETENT LICENSEE OR HIS/HER ESTATE
TITLE OR CAPACITY
LICENSEE NAME (Last, first, middle)
DOING BUSINESS AS (DBA)
PREMISES ADDRESS (Street number and name, city, zip code)
Instructions:Pursuant to Section 23102 of the Alcoholic Beverage Control Act and Section 79(a) of the California Code of Regulations, you are hereby permitted to sell alcoholic beverages under authority of the license described below.
If an application to transfer the license is to be filed, it should be submitted as soon as possible inorder that the transfer may be completed on or before the expiration date described below.
This permit must be posted on the premises.
PERMIT EXPIRATION DATE
FOR ABC USE ONLYDISTRICT ADMINISTRATOR/DISTRICT SUPERVISOR SIGNATURE DATE SIGNED
DISTRICT OR BRANCH OFFICE
Distribution:Original - To Person Acting on Behalf of Licensee or Licensee's EstateCopy - To District OfficeCopy - To Headquarters
Person name: title: licensee name: dba: premises address: