Application for liquor permit – all areas except East Arnhem, Maningrida and Groote Eylandt
Application for liquor permit – all areas except East Arnhem, Maningrida and Groote EylandtApplicant details
Title / Mr Mrs Ms Miss
Full name (include middle name)
Date of birth
Residential address in community
Telephone / Email
Please choose from the following
I am a permanent resident
I am a contractor
I am a tourist
I will be in the below community between (enter dates) / and
Location(Please tick your location and specify as needed)
Barunga / Beswick
Gunbalanya / Jay Creek
Kalkaringi / Lajamanu
Nauiyu / Peppimenarti
Tiwi Islands / Wadeye
Wudikapildiyea / Yuendumu
Other: (insert nearest community)
Specify community or permit type
In applying for this permit I understand and give approval for the relevant authority to conduct any checks, to ascertain if I am a fit and proper person to hold a liquor permit. I also understand that a breach of the criteria may result in my permit being revoked
Applicant’s signature / Date
Permit criteria
That the applicant has not:
a)caused substantial annoyance or disrupted community order and peace; or
b)assaulted any person or been involved in alcohol-related domestic or family violence or traffic or vehicular incidents; or
c)illegally brought liquor into, or possessed liquor in, a restricted area; or
d)brought a dangerous drug (defined in the Misuse of Drugs Act) into, or possessed a dangerous drug in, a restricted area; or
e)supplied liquor to another person who is not a permit holder or who is not an invited guest of the permit holder; or
f)supplied a dangerous drug to another person; or
g)been banned from any of the licensed premises in the restricted area; or
h)breached any of the conditions of the permit or;
i)upon notification that an order has been made by any Court or Tribunal prohibiting a person from possessing, consuming or purchasing liquor
Specific conditions
Tiwi Islands: Liquor may only be taken into the restricted area via Tiwi barge, after being purchased from a retailer situated outside the Tiwi Islands.
The maximum limits that may be taken into the restricted area by permit holders on a
weekly basis is one of the following:
One (1) carton of light beer (24 x 375ml cans, less than 3%),or One (1) carton of mid-strength beer (24 x 375ml cans, 3% - 4%),or Two (2) six packs of full strength beer (12 x 375ml cans, over 4%),or Two (2) six packs of premix drinks (12 x 375ml),or Three (3) bottles of wine (750ml, not fortified)
Yuendumu:For the duration of the sports weekend, no liquor is to be consumed at the community by permit holders
Other special conditions determined by committee and/or police (if applicable)
Recommendation/approval
Council/Permit Committee Chair / Recommended Not recommended
Name
Signature / Date
Police delegate / Recommended Not recommended
Reason if not recommended:
Name
Signature / Date
Decision-maker / Approved Not approved
Name
Signature and title / Date
Permit number / Expiry date
General terms and conditions required as a holder of a liquor permit
1. / Applicants must have attained the age of 18 years and be a resident of the general restricted area
2. / The permit holder may only possess and consume liquor at their home residence or the residence of other permit holders within the general restricted area the permit relates to or those areas are defined as exempt within the restricted area
3. / A permit may be revoked by the decision-maker at their discretion
4. / A permit may also be revoked upon application to the decision-maker signed by the Liquor Permits Committee or a member of the NT Police if the permit holder does one or more of the following:
a)caused substantial annoyance or disrupted community order and peace; or
b)assaulted any person or been involved in alcohol-related domestic violence or traffic or vehicular incidents; or
c)illegally brought liquor into, or possessed liquor in a restricted area; or
d)brought a dangerous drug (defined in the Misuse of Drugs Act) into, or possessed a dangerous drug in, a restricted area; or
e)supplied liquor to another person who is not a permit holder or who is not an invited guest of the permit holder; or
f)supplied a dangerous drug to another person; or
g)been banned from any of the licensed premises in the restricted area: or
h)breached any conditions of the permit; or
i)upon notification that an order has been made by any court or Tribunal prohibiting a person from possession, consuming or purchasing liquor
5. / A person whose permit has been revoked may reapply for a new liquor permit by submitting a new application form
6. / Permits are granted for three years unless an end date is specified in the application
For more information please contact:
Licensing NT
Phone / (08) 8999 1800 / Fax / (08) 8999 7498
Email /
Please send the completed form (including recommendations from Council/Permit Committee Chair and NT Police) to Licensing NT by email or fax to the details above
Department of the attorney-general and justicePage 1 of 3
22 February 2018