REIGNING GRACE RANCH - REDACTED.PDF

SECTION 10
1. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
EIYes E No (If yes, attach explanation.)
2. How many special event licenses have been issued to this location this year? 0
(The number cannot exceed 12 events per year exceptions under A.R.S. §4-203.02(D).)
3. Is the organization using the services of a promoter or other person to manage the event? OYes 'No
(If yes, attach a copy of the agreement.)
4. List all people and organizations who will receive the proceeds. Account for 100% of the proceeds. The
organization applying must receive 25% of the gross revenues of the special event liquor sales. Attach an
additional page if necessary,
Name Reigning Grace Ranch Percentage 75%
Address 28150 N Alma School Pkwy, Ste 103-481, Scottsdale AZ 85262
Street City State Zip
Name Percentage
Address
Street City State Zip
5. Please read A.R.S. §4-203.02 Soecial event license; rules and R19-1-205 Reauirements for a Special Event License,
Note: ALL ALCOHOLIC BEVERAGE SALES MUST BE FOR CONSUMPTION AT THE EVENT SITE ONLY
"NO ALCOHOLIC BEVERAGES SHALL LEAVE SPECIAL EVENT UNLESS THEY ARE IN AUCTION SEALED CONTAINERS
OR THE SPECIAL EVENT LICENSE IS STACKED WITH WINE /CRAFT DISTILLERY FESTIVAL LICENSE"
6. What type of security and control measures will you take to prevent violations of liquor laws at this event?
(List type and number of police/security personnel and type of fencing or control barriers, if applicable.)
0 Number of Police 2 Number of Security Personnel OFencing OBarriers
Explanation: The fundraiser will be offered in a retired community, we do not anticipate senior retirech
individuals and families to be out of control.
SECTION 11 Date(s) and Hours of Event. May not exceed 10 consecutive days.
See A.R.S. §4-244(15) and (17) for legal hours of service.
Date Day of Week Event Start License End
Time AM/PM Time AM/PM
DAY I: 4118/15 Saturday 5:30-9pm 5:30pm-9:00r
DAY 2:
DAY 3:
DAY 4:
DAY 5:
DAY 6:
DAY 7:
DAY 8:
DAY 9:
DAY 10:
10117/14 Page 2 of 4
Individuals requiring ADA accommodations call (602)542-9027.

SECTION 12 License premises diagram. The licensed premises for your special event is the area in which you are
authorized to sell, dispense or serve alcoholic beverages under the provisions of your license, The following
space is to be used to prepare a diagram of your special event licensed premises. Please show dimensions,
serving areas, fencing, barricades, or other control measures and security position.

SECTION 13 This section is to be completed only by an Officer, Director or Chairperson of the organization
named in Section 1.
I, Aina-40/0-Q--) /4' 68r-e declare that 1 am an OFFICER, DIRECTOR, or CHAIRPERSON
fPrint full name}
appointing the applicant listed in Section 9, to apply on behalf of the foregoing organization for a Special Event
Liqu
1/A I 19-c110
X 4/eedwk, D 1S- z--147
Date Phone #
The foregoing instrument was acknowledged before me this dhlom, r
State cA N4-\, -L-cyIc,,. County of c\-\Z-N-I.6_,R LeN R. AZA
Wary Publi0- St* 01
MAF1COPA
My Commission Commission Expires on: aplfsckno 0, 7
Signature of Notary Public
SECTION 14 This section is to be completed only by the applicant named in Section 9.
Tholida.) o'OlC declare that I am the APPLICANT filing this application as
!Print full name)
listed in Section 9. I have read the application and the contents and all statements are true, correct and
/ Title/ h Position Date S 11;:odn: iC2t IP I ;*
The foregoing instrument was acknowledged before me this -4\N) -&I )
OFFICIAL SEAL
State `c\b Ic-NZ. County of LORI R. AZAR
NOtery PrIbtic - Stale of Arizors
MA Flo COPA COUNTY
My Commission Expires on: Rpires June 0, 2017
The local governing body may require additional applications to be completed and submitted, Please check with
local government as to how far in advance they require these applications to be submitted. Additional licensing
fees may also be required before approval may be granted. For more information, please contact your local
iurisdiction: http://www.azliquor.gov/assets/documents/homepage docs/spec event links.pdf.
SECTION 15 Local Governing Body Approval Section
recommend 0 APPROVAL 0 DISAPPROVAL
(government officio!) Mite)
on behalf of
(city, Town, county] Signature Date Phone
FOR DEPARTMENT OF LIQUOR LICENSES AND CONTROL USE ONLY
0APPROVAL 0 DISAPPROVAL BY: DATE:
10/17/14 Page 4 of 4
Individuals requiring ADA accommodations call (602)542-9027.