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MONTANA
                                                                           Return to:                               SpecPerm
                                                                           Montana Department of Revenue
                    Application For Special                                                                         Rev. 4-03
                                                                           Registration and Licensing
                 Permit to Sell Beer/Table Wine                            P.O. Box 1712
                                                                           Helena, MT 59604-1712


Check type of organization:                                                                           Fee:

  501(c)(3) organization (limit up to 3 per year) *                                                   $10 per day
  501(c)(3) intercollegiate athletic fund-raising organization (limit up to 12 per year) *            $10 per day
  501(c)(4) civic league or organization (limit up to 12 per year)*                                   $10 per day
  501(c)(6) chamber of commerce or business league (limit up to 12 per year)*                         $10 per day
       (Must provide proof of liquor liability insurance)
  Accredited Montana post secondary school (limit up to 3 per year)                                   $10 per day
  An organization operated to raise funds for a needy person                                          $10 per day
  Licensed veterans or fraternal organization (limit up to 3 per year)                                $10 per day
  Professional sports organization (seasonal)                                                         $1,000 per season
  Junior hockey team (seasonal)                                                                       $1,000 per season
       *A copy of your IRS tax exempt certificate must be attached or on file with the department

                                           Section 1: Applicant Information

Applicant_____________________________________________________________________________________________

Address______________________________________________________________________________________________
                             Street              City                State        Zip
Purpose for event ________________________________________________________________________________

Date(s) for which special permit is desired ____________________________________________________________

Exact location where beer/table wine will be sold and consumed___________________________________________

                                         Section 2: Local Law Enforcement
To be completed by a local law enforcement official:
  I approve of the described event ___________________________________________________________________
                                                                         Print name and title
Signature and date _____________________________________________________________________________

  I disapprove of the described event_______________________________________________________________
                                                                         Print name and title
Signature and date _____________________________________________________________________________

                                    Section 3: Applicant Acknowledgment
Beer/table wine will be sold and consumed within the enclosure where the event is to be held and only on the above-
designated date(s). The location of the event is not within 600 feet and on the same street as a school or church.

The application, applicable fee, and approval of local law enforcement must be received by the Department of Revenue,
Registration and Licensing, three days in advance of the earliest date for which the permit is desired.

If granted a permit, the applicant, any agent, or employee will abide by all the laws, rules and ordinances, relating to
the sale of beer and table wine. The applicant understands that violation of any department rule, state, or any local
ordinance relating to the sale of beer or table wine by the applicant, any agent, or employees, shall be sufficient
grounds to revoke the permit. Any authorized employee of the Department of Revenue, or its duly appointed
representative and/or any peace officer of this State shall have the right to examine the permittee’s premises at any
time.
__________________________________________________________________________________________________________________
Print name and title of authorized official of applicant

_______________________________________________________                                ___________________________________
Signature of authorized official of applicant                                          Federal ID Number for Applicant
(_____)______________________                                                          (______)______________________
Contact Phone Number                                                                   Fax Number
                                                                                                                     501
Samples of Qualified Organizations


An organization or institution that has a tax-exempt designation under section
501(c)(3) of the Internal Revenue Code

An organization or institution that is organized and operated to raise funds for a needy
person

An accredited Montana postsecondary school

A civic league or organization that has a tax-exempt designation under section
501(c)(4) of the Internal Revenue Code

An organization authorized by an accredited Montana Postsecondary school to engage
in fund-raising activities for intercollegiate athletics that has a tax-exempt designation
under the provisions of section 501(c)(3) of the Internal Revenue Code (Only one
organization for each Montana postsecondary school may be authorized under this
section)

An association or corporation engaged in professional sporting contest or junior
hockey contests

A chamber of commerce or business league that has a tax-exempt designation under
section 501(c)(6) of the Internal Revenue Code (The chamber of commerce or business
league receiving a special permit must obtain liquor liability insurance for any event
conducted)

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gov revenue formsandresources forms SpecPerm

  • 1. MONTANA Return to: SpecPerm Montana Department of Revenue Application For Special Rev. 4-03 Registration and Licensing Permit to Sell Beer/Table Wine P.O. Box 1712 Helena, MT 59604-1712 Check type of organization: Fee: 501(c)(3) organization (limit up to 3 per year) * $10 per day 501(c)(3) intercollegiate athletic fund-raising organization (limit up to 12 per year) * $10 per day 501(c)(4) civic league or organization (limit up to 12 per year)* $10 per day 501(c)(6) chamber of commerce or business league (limit up to 12 per year)* $10 per day (Must provide proof of liquor liability insurance) Accredited Montana post secondary school (limit up to 3 per year) $10 per day An organization operated to raise funds for a needy person $10 per day Licensed veterans or fraternal organization (limit up to 3 per year) $10 per day Professional sports organization (seasonal) $1,000 per season Junior hockey team (seasonal) $1,000 per season *A copy of your IRS tax exempt certificate must be attached or on file with the department Section 1: Applicant Information Applicant_____________________________________________________________________________________________ Address______________________________________________________________________________________________ Street City State Zip Purpose for event ________________________________________________________________________________ Date(s) for which special permit is desired ____________________________________________________________ Exact location where beer/table wine will be sold and consumed___________________________________________ Section 2: Local Law Enforcement To be completed by a local law enforcement official: I approve of the described event ___________________________________________________________________ Print name and title Signature and date _____________________________________________________________________________ I disapprove of the described event_______________________________________________________________ Print name and title Signature and date _____________________________________________________________________________ Section 3: Applicant Acknowledgment Beer/table wine will be sold and consumed within the enclosure where the event is to be held and only on the above- designated date(s). The location of the event is not within 600 feet and on the same street as a school or church. The application, applicable fee, and approval of local law enforcement must be received by the Department of Revenue, Registration and Licensing, three days in advance of the earliest date for which the permit is desired. If granted a permit, the applicant, any agent, or employee will abide by all the laws, rules and ordinances, relating to the sale of beer and table wine. The applicant understands that violation of any department rule, state, or any local ordinance relating to the sale of beer or table wine by the applicant, any agent, or employees, shall be sufficient grounds to revoke the permit. Any authorized employee of the Department of Revenue, or its duly appointed representative and/or any peace officer of this State shall have the right to examine the permittee’s premises at any time. __________________________________________________________________________________________________________________ Print name and title of authorized official of applicant _______________________________________________________ ___________________________________ Signature of authorized official of applicant Federal ID Number for Applicant (_____)______________________ (______)______________________ Contact Phone Number Fax Number 501
  • 2. Samples of Qualified Organizations An organization or institution that has a tax-exempt designation under section 501(c)(3) of the Internal Revenue Code An organization or institution that is organized and operated to raise funds for a needy person An accredited Montana postsecondary school A civic league or organization that has a tax-exempt designation under section 501(c)(4) of the Internal Revenue Code An organization authorized by an accredited Montana Postsecondary school to engage in fund-raising activities for intercollegiate athletics that has a tax-exempt designation under the provisions of section 501(c)(3) of the Internal Revenue Code (Only one organization for each Montana postsecondary school may be authorized under this section) An association or corporation engaged in professional sporting contest or junior hockey contests A chamber of commerce or business league that has a tax-exempt designation under section 501(c)(6) of the Internal Revenue Code (The chamber of commerce or business league receiving a special permit must obtain liquor liability insurance for any event conducted)