Form C-815

Trade Name:

Permit / License Number:

Contact Name: Telephone No.: ()-

Gentlemen:

In accordance with the electronic reporting requirements contained in Rule 45.121(e) for Credit Law and/or Rule 45.131(e) for Cash Law, I am submitting an exception request under Section (e)(2)(a) for the following reason(s):

Distributors, Wholesalers, & Manufacturers / Brewers that produce less than 225,000 BBL’s.

My business is small and I do not currently use or have access to a computer. I request permission to manually file notarized paper affidavits to report cash or credit law violations to the Commission.

Wineries:

My business is small and I do not currently use or have access to a computer. I request permission to manually file notarized paper affidavits to report credit law violations to the Commission

I do not currently sell or plan to sell to retail outlets.

Local Distributors (LP):

My business is small and I do not currently use or have access to a computer. I request permission to manually file notarized paper affidavits to report cash or credit law violations to the Commission

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Requestor’s Signature: Date

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TABC Approval Date

Please mail or fax completed form to the attention of the Audit Supervisor in your respective region:

Region 1 – 500 Chestnut Street, Ste. 1573, ABILENE, Texas 79602 – Fax (325) 670-9838

Region 2 – 2225 East Randol Mill, Ste. 200, ARLINGTON, Texas 76011 – Fax (817) 607-2492

Region 3 – 427 West 20th Street, Ste. 600, HOUSTON, Texas 77008 – Fax (713) 426-7979

Region 4 – 7700 Chevy Chase Drive, Ste. 200, AUSTIN, Texas 78752 – Fax (512) 451-0240

Region 5 – 4203 Woodcock Drive, Ste. 120, SAN ANTONIO, Texas 78228 – Fax (210) 731-1759

NOTE: Notifications must be received at least two business days prior to the list publication date.

P.O. Box 13127 Austin, Texas 78711-3127 (512) 206-3333

An Equal Opportunity Employer