Form Center

2. DATE:
   DATE:
4. Name of Business:*
6. Email:*
8. Phone:*
10. Authorized Signature:*
12. License Type:

    1. Limited Restaurant Drink $800.00
    2. NQ Type 2 Retail Drink $800.00
    3. Limited Golf Course $800.00
    4. Special Sunday Retail Drink $300.00
    5. NQ Retail Malt Beverage Package $200.00
    6. NQ 4 Retail Malt Beverage Drink $200.00
    7. Quota Retail Package $600.00
    8. Quota Retail Drink $600.00
    9. Catering $800.00
    10. Private Club $300.00
    11. Distiller's $500.00
    12. Rectifier's Class A $3000.00
    13. Rectifier's Class B $960.00
    14. Microbrewery $500.00
    15. Malt Beverage Distributers $400.00
    16. Bottling House or Bottling House Storage $1000.00
14. Upon receipt of this signed form and payment your license renewal will be emailed to you. Fees can be paid online @ www.georgetownky.gov
16. Click Blue pay online button(on home page), then fee payment and then choose alcohol license/regulatory fees or link below.
18. Pay here online:
    Alcohol License Fee
Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field