Get 20528878

Filling out the 20528878 form, also known as the Affidavit of Lost or Replacement Mixologist/Server Permit, is essential for individuals needing to replace a lost permit. This guide provides clear, step-by-step instructions to help you complete the form with confidence.

Follow the steps to successfully complete the 20528878 form online.

1. Press the ‘Get Form’ button to obtain the form and open it in your online editor.
2. Identify the purpose of your application by checking the box for 'Lost Permit' or 'Name Change'. If you know your permit number, include that information.
3. Enter the date of the original class you attended.
4. Indicate whether you are certified for Class 12 or Class 13 by checking the appropriate boxes.
5. Fill in your last name, former name (if applicable), first name, and middle initial.
6. Provide your social security number and date of birth.
7. Record your present mailing address, including city, state, and zip code.
8. Complete the section for sex, height, weight, and provide a contact phone number.
9. Enter the name of your employer and their contact phone number.
10. Sign the form in the designated area to certify that all answers are true and complete, and date it.
11. Submit your payment of $5.00 by sending a check to the specified address.
12. Once completed, save the form changes, and consider downloading or printing it for your records.

Start filling out the 20528878 form online today!