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Application for New Brewery, Micro Brewery, or Brewpub
&
1 Contacts
Location

2 Application
Information

3 Business
Information

and
4 Review
Submit

5 Record Submittal

Step 1 : Contacts & Location > Business Contacts
* indicates a required field.

Application Contact
Please enter information about the contacts associated with this application. Only those contact types required for your specific
application will be listed. A description of each contact type follows:
Application Contact: This information pertains to the primary person who will track the application in Permits Online and receive email
notifications from TTB. The Person listed as the Application Contact must be a registered user of Permits Online.
Business Headquarters: This information pertains to the actual business entity or person applying for approval. In this section, you
will supply the name of the business as it will be shown on any forms, permits, or bonds, so it is important that you
carefully and accurately complete that information. Please refer to our field specific Help button for details.
Mailing Address: This is the name of the business, person or entity to which you want any mail to be addressed.
Officer-Owner: This information pertains to the individual person that will be listed on the original or amended application filed with TTB
as an officer, owner, member, or partner with the applicant entity. All address fields refer to the legal residence (home address) for the
application contact person identified in this section. A separate Officer/Owner Information Application must be filed for each individual.

Auto-fill with
* First Name:

Christopher Dudley

Middle Name:

* Last Name:

Position/Title:

Business Name:

Address:

* City:

* State:

* Zip:

--Select--

Country:
--Select--

* Primary Phone:

Alternate Phone:

Fax:

E-mail:

Business Headquarters
Please enter information about the contacts associated with this application. Only those contact types required for your specific
application will be listed. A description of each contact type follows:
Application Contact: This information pertains to the primary person who will track the application in Permits Online and receive email
notifications from TTB. The Person listed as the Application Contact must be a registered user of Permits Online.
Business Headquarters: This information pertains to the actual business entity or person applying for approval. In this section, you
will supply the name of the business as it will be shown on any forms, permits, or bonds, so it is important that you
carefully and accurately complete that information. Please refer to our field specific Help button for details.
Mailing Address: This is the name of the business, person or entity to which you want any mail to be addressed.
Officer-Owner: This information pertains to the individual person that will be listed on the original or amended application filed with TTB
as an officer, owner, member, or partner with the applicant entity. All address fields refer to the legal residence (home address) for the
application contact person identified in this section. A separate Officer/Owner Information Application must be filed for each individual.

Auto-fill with

Christopher Dudley

* Business Name:

* Employer Identification Number

Address:

* City:

* State:

* Zip:

--Select--

Country:
--Select--

* Primary Phone:

Alternate Phone:

Fax:

https://test.ttbonline.gov/permitsonline/Cap/CapEdit.aspx?Module=Alcohol&stepNumber... 10/25/2013

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https://test.ttbonline.gov/permitsonline/Cap/CapEdit.aspx?Module=Alcohol&stepNumber... 10/25/2013