Arizona > Statewide > Liquor Licenses And Control
Applicant Of Controlling Person Affidavit LIC0107 - Arizona
| Applicant Of Controlling Person Affidavit Form. This is a Arizona form and can be used in Liquor Licenses And Control Statewide . |
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Print Form American LegalNet, Inc. www.FormsWorkFlow.com 3. There are, in addition to those submitting questionnaires and fingerprint cards, other officers, limited liability members, and/or board members of this organization who are not submitting such information to the Arizona Department of Liquor Licenses and Control. None of these individuals directs or is involved in the direction of the management of policies of this organization involving spirituous liquor in the State of Arizona. Such members and positions, along with date and place of birth, are as follows (or list attached): (1) (2) (3) (4) 4. None of the individuals listed under item #3 possesses the power to vote ten percent (10%) of the outstanding voting securities of this organization, nor can any of them control the election of one or more of the Board of Directors or managing members of the organization. 5. Finally, on information and belief, none of the individuals listed under item #3 have at any time been convicted of a felony, had a liquor license revoked, or violated any provisions of a liquor license issued to that member. DATED this Day day of Month , Year I, (Print full name) , declare that I am the APPLICANT filing this notification. I have read this document and the contents and all statements are true, correct and complete. X (Signature) State of County of The foregoing instrument was acknowledged before me this day of Day Month , Year My commission expires on: (Date) (Signature of NOTARY PUBLIC) American LegalNet, Inc. www.FormsWorkFlow.com
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