Get Mi Lc-95 2017-2026

Filling out the MI LC-95 form accurately is essential for maintaining proof of financial responsibility with the Michigan Liquor Control Commission. This guide will walk you through each section of the form, ensuring you understand the requirements and procedures involved.

Follow the steps to complete the MI LC-95 form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the Licensee Mailing Address. This address will be used for all correspondence with the MLCC, and it may differ from the licensed business address.
3. Complete the Licensee Information section. For each licensed location, input the license number (including its prefix), the licensee's name, and the business address.
4. Choose the type of proof for Financial Responsibility. You must check one box from options 3 through 10 indicating the chosen method (like liquor liability insurance, cash, or other options).
5. If selecting Liquor Liability Insurance, provide the effective date, policy number, and the insurance company’s name and address. Ensure the policy meets the minimum coverage requirement of $50,000.
6. Complete the relevant section for the selected method of proof, ensuring to include all required attachments such as the constant value bond document, or pledge agreement as necessary.
7. Enter the date the form is completed.
8. Fill in the daytime phone number for the authorized insurance agent or bank representative.
9. Input the name and title of the authorized agent or bank representative. Ensure they provide their signature in the designated area.
10. Review all entries for accuracy. After confirming that everything is correct, save changes, and download or print the completed form for submission.

Act now to complete your MI LC-95 form online and ensure compliance with Michigan's liquor licensing requirements.