(1213) Application for Authorization to Contract Out

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
Authorization to Contract Out
The applicant must file a completed Application
for Authorization to Contract Out (together with
the Liquor Sales Licence Transfer Application and
transfer fee) if the applicant intends to operate
during the transfer process.
The applicant may not operate until they have
received the "Authorization To Contract Out" from
the Registrar of Alcohol and Gaming.
The licence holder is still responsible for
compliance with all requirements of the licence
during this authorization period.
An Authorization to contract out expires when the
licence is transferred, expires or when a notice of
proposal to refuse the transfer is issued.
Both the licence holder and the transfer applicant
must sign both the Transfer application and the
Application for Authorization to Contract Out.
Application for Authorization
to Contract Out
If the applicant is:

a sole proprietor, the applicant must
sign and date the form.

a corporation, a person with
authority to bind the applicant
corporation must sign and date the
form.

a partnership, all partners must sign
and date the form.
If the current licence holder is:

a sole proprietor, the owner must sign
and date the form.

a corporation, a person with
authority to bind the licensee
corporation must sign and date the
form.

a partnership, all partners must sign
and date the form.
Contact Information
Mail or deliver your complete application to:
Contact the AGCO Customer Service at 1 800
522-2876 or 416 326-8700 if you have any
questions.
ALCOHOL & GAMING COMMISSION OF ONTARIO
LICENSING AND REGISTRATION
90 SHEPPARD AVE E
SUITE 200
TORONTO ON M2N 0A4
Application forms and guides are available from
our website at: www.agco.on.ca
INCOMPLETE APPLICATIONS WILL BE RETURNED TO THE APPLICANT.
1213E (2006/05)
© Queen’s Printer for Ontario, 2006
Disponible en français
Page 1 of 2
Application for Authorization
to Contract Out
Demande d’autorisation
de sous-traiter
Alcohol and Gaming
Commission des alcools
Commission of Ontario
et des jeux de l’Ontario
Inscription et délivrance des permis
Licensing and Registration
90 SHEPPARD AVE E
90 AV SHEPPARD E
BUREAU 200
SUITE 200
Toronto ON M2N 0A4
Toronto ON M2N 0A4
Tel./Téléphone : 416 326-8700
Fax/Téléc. : 416 326-5555
1 800 522-2876 toll free in Ontario/sans frais en Ontario
Website/site Web : www.agco.on.ca
1.
Establishment Information / Renseignements sur l’établissement
Establishment name as appears on the transfer application / Nom de l’établissement, tel qu’il figure sur la
Demande de cession
Licence Number /
No de permis
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
(
)
—
2.
Current Licence Holder(s) / Titulaire(s) actuel(s) du permis
If a Corporation, fill in the name of the corporation and have an authorized signing officer sign the form.
Personne morale? Indiquer la dénomination sociale de la société et faire signer par un signataire autorisé.
Corporation / Personne morale
Signature
Date
If a Sole Proprietor, print name below and sign. If a Partnership, have all partners print their names below and sign. / Entreprise personnelle?
Indiquer ci-dessous votre nom (propriétaire) et signer. Société en nom collectif? Tous les associés doivent indiquer leur nom et signer.
Print name / Nom en lettres moulées
Signature
Date
Print name / Nom en lettres moulées
Signature
Date
Print name / Nom en lettres moulées
Signature
Date
I/We, the current Licence Holder(s), agree to permit the applicant(s) named below to operate this establishment. / Je / Nous, le(s) titulaire(s)
actuel(s) du permis, autorise / autorisons l’auteur ou les auteurs de la demande indiqués ci-dessous à exploiter l’établissement.
3.
Transfer applicant(s) / Auteur(s) de la demande de cession
Print name / Nom en lettres moulées
Signature
Date
Print name / Nom en lettres moulées
Signature
Date
Print name / Nom en lettres moulées
Signature
Date
By signing this form, both the current licence holder and the transfer applicant acknowledge responsibility for the operation of the establishment and
that any violation of the Liquor Licence Act and Regulations may result in licence revocation/suspension or refusal of the transfer application. /
En signant cette demande, le titulaire actuel du permis et l’auteur de la demande de cession reconnaissent qu’ils sont tous deux responsables de
l’exploitation de l’établissement et que toute infraction à la Loi sur les permis d’alcool et à ses règlements peut entraîner la révocation ou la
suspension du permis ou le rejet de la demande de cession.
1213 (2006/05)
© Queen’s Printer for Ontario, 2006 / © Imprimeur de la Reine pour l’Ontario, 2006
Clear Form Entries / Effacer des entrées de la Formule
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