Neighborhoods and Housing Services Department
Regulated Industries Division
635 Woodland Ave., Suite 2101
Employee Liquor Permit Application Kansas City, MO 64106
(816) 513-4561
Applications are accepted from 8:00 a.m. to 4:30 p.m. Monday – Friday at the Regulated Industries Division office. All applicants must be authorized to work in the United States. All applicants must submit a completed application and:
•Payment (only cash, Discover, Master Card or Visa are accepted – checks are not accepted) must be submitted
•One of the following:
oA $40 non-refundable application fee which includes a criminal background investigation, or;
oA $16 non-refundable application fee (you must choose a licensed background investigation company, approved by the director, to complete a criminal background investigation. A background investigation completed from a licensed background investigation company will only be accepted if it has been completed within sixty (60) days from the date your application is submitted)
All applicants who are not renewing a current permit that has not expired must submit the following:
•A valid State Issued Driver's License or ID must be submitted
•Along with a valid State Issued Driver's License or ID, one of the following original documents must be submitted: Social Security Card without employment restriction; U.S. Passport or Passport Card; Permanent Resident Card [i.e., Green Card]; Foreign Passport with I-551 stamp MRIV; Temporary I-551 paper card with picture of applicant which states “employment authorized” until specified date; Employment Authorization Card; Form I-20 accompanied by Form I-94 or Form I-94A; Form DS-2019 accompanied by Form I-94 or Form I-94A; or Form I-94; Form I-94A Arrival/Departure Record; Birth certificate issued by the U.S. Department of State; U.S. Citizen Identification Card Form I-197; or Identification Card for Use of Resident Citizen in the U.S. Form I-179. Fake, false or altered identification cards will be confiscated.
If an applicant fails to submit their correct social security number they will be required to pay an additional $39 dollars to complete a second background check and a second temporary permit will not be issued.
There are restrictions listed under section 10-291 of the Code of Ordinances of the City of Kansas City, Missouri, that may prohibit you from receiving an Employee Liquor Permit. Please read below to determine your eligibility:
•An Employee Liquor Permit, with no restrictions, shall not be issued to any person who is not at least 21 years of age. Persons 18 through 20 years of age may receive an Employee Liquor Permit with additional restrictions and limitations. See section 10-373 of the Code of Ordinances of the City of Kansas City, Missouri for more details.
•An Employee Liquor Permit will never be issued to any person who is a dangerous offender, persistent sexual offender or predatory sexual offender.
•An Employee Liquor Permit will never be issued to any person who has been found guilty of, pleaded guilty to, pleaded nolo contendere to or been convicted of a felony (federal or any state) for first or second degree murder, voluntary manslaughter, forcible first or second degree rape, first degree statutory rape, forcible first or second degree sodomy, first degree statutory sodomy, first or second degree or child kidnapping, false imprisonment, first or second or third degree child molestation, second degree child molestation, first or second degree sexual trafficking of a child, first degree sexual abuse or an attempt to commit any of the preceding crimes or an offense of a similar nature in other states as determined by the director.
•An Employee Liquor Permit will not be issued to any person who, within five years of the date of application, has been found guilty of, pleaded guilty to, pleaded nolo contendere to or been convicted of a felony (federal or any state) or has been released from confinement for a felony conviction, whichever is latest, involving a crime against a person for first or second degree assault, first or second degree domestic assault, first or second degree robbery, armed criminal action, sexual exploitation of a minor, and trafficking for the purpose of sexual exploitation.
•An Employee Liquor Permit will not be issued to any person who is disqualified by state statutes or by the Code of State Regulations for employment on the licensed premises of an alcoholic beverage establishment.
Name ________________________________________________________________ Phone _____________________________
FirstMiddleLast
Address ___________________________________________________________________________________________________
NumberStreetApartment # City/StateZip Code
Email address _________________________________________ Mobile Phone ________________________
Driver's License or State ID Number __________________________________________________State Where Issued ________
Height __________ Weight __________ Gender _____ Eye Color __________________Hair Color ___________________
Social Security Number ______________-____________-__________________ Date of Birth _______ / _______ / ___________
Month Day Year
At which business will you be working where an Employee Liquor Permit is required? ____________________
__________________________________________________________________________________________
Have you ever been denied an Employee Liquor Permit or had one suspended or revoked? Yes No If yes, provide the following information:
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|
|
|
|
Date |
Reason for Suspension/Revocation |
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Where (City and State) |
_____________________ |
_____________________________________________________ |
___________________________________________ |
_____________________ |
_____________________________________________________ |
___________________________________________ |
Have you ever been convicted of a felony? |
Yes No |
If yes, provide the following information: |
Date |
Offense/Conviction Charge |
|
Where (City and State) |
_____________________ |
_____________________________________________________ |
___________________________________________ |
_____________________ |
_____________________________________________________ |
___________________________________________ |
If you were incarcerated, you must provide the date of your release: ____________________.
You may request to have your Employee Liquor Permit mailed to you at the address you indicated above. If you choose to have your permit mailed to you and your permit is returned to us, you will be required to return to Regulated Industries to pick up your permit. If you choose to have your permit mailed to you and your permit is lost in the mail, you will be required to return to Regulated Industries and pay a $10 replacement fee before your permit will be issued. Please choose one of the following options:
Please mail my Employee Liquor Permit to me for an additional $1.00 (only an option if you submit your application in person along with all required identification)
I will return to Regulated Industries Division to pick up my Employee Liquor Permit (required if all forms of identification are not presented w/ application – allow three weeks for processing and call our office to ensure your permit is ready for pick-up)
I hereby authorize law enforcement, probation and parole agencies to release all information pertaining to my criminal record and I authorize a Social Security number trace. I understand that furnishing false or incomplete information on this application may be grounds for denial of the permit. I also understand that there is no refund of the fee which accompanies this application if, for any reason, it is denied.
I have familiarized myself with the provision of Chapters 10 and 50, Code of Ordinances of the City of Kansas City, Missouri and agree to comply with these provisions in the conduct of this business and I will not violate any of the ordinances of the city, laws of the state or laws of the United States in the conduct of the business.
Applicant's Signature _____________________________________________ Date ______________________
Office Use Only
Did the criminal background investigation prove the applicant to be a prohibited felon? Yes No An Employee Liquor Permit was Approved Denied
Processed by _____________________________ |
Date ____ / ____ / _____ Certificate # ________________________ |
Customer Service Representative |
Month Day |
Year |
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8-21-2019 |
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