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Affidavit For Removal Of Ownership Interest - Kentucky

Affidavit For Removal Of Ownership Interest Form. This is a Kentucky form and can be used in Miscellaneous Alcohol Beverage Control Statewide .
 Fillable pdf Last Modified 7/17/2014
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ABC Name Drop Aff. Revised June 2013 COMMONWEALTH OF KENTUCKY DEPARTMENT OF ALCOHOLIC BEVERAGE CONTROL 1003 Twilight Trail Frankfort, Kentucky 40601-8400 502-564-4850 phone 502-564-1442 fax http://abc.ky.gov AFFIDAVIT FOR REMOVAL OF OWNERSHIP INTEREST STATE OF KENTUCKY COUNTY OF ____________________ The affiant, _______________________________________, Social Security Number __________________, being first duly sworn, deposes and says: The affiant is over the age of twenty-one years and resides at _____________________________________ ______________________________________, in the City of _________________________________________, in the State of _____________________________________________, being in the County of __________________________; The affiant is listed in the application as having an interest in ABC Alcohol License Number(s) ____________________________________________________________________ located at __________________________________________________________________________________________________, in the City of ________________________________________________, Kentucky, in the County of _________________; The affiant no longer has any ownership in said license(s) or business(es) and hereby asks that the Department's records reflect the same. X_____________________________________________________ Signature of Affiant I, the undersigned, a Notary Public in and for the State and County aforesaid, hereby certify that the affiant, _________________________, personally appeared before me and swore to the foregoing statements. Witness my hand this _____________day of _____________________, 20_____ X ____________________________________________________ Notary Public State of ______________________________ at Large My Commission Expires: _________________________ County of ______________________________ at Large Notary ID#__________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com
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