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Affidavit (Credit Law - Liquor) C-807 - Texas
| Affidavit (Credit Law - Liquor) Form. This is a Texas form and can be used in Alcoholic Beverage Commission Statewide . |
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FORM C-807 (08/2010) AFFIDAVIT (CREDIT LAW LIQUOR) STATE OF TEXAS COUNTY OF ___________________________ BEFORE ME, the undersigned authority, this day personally appeared _________________________, who is a credible person, and who, after being by me duly sworn, did depose and say: THAT: the _______________________________ (Trade Name), Permit No. ____________, located at _______________ __________________________________ (Address) failed to pay in a timely manner, liquor purchased under credit terms in violation of the TABC CODE Section 102.32 and TABC Rule 45.121. This has resulted in the retailer being placed on the Official State Delinquent List for the following delivery periods: Delivery Period ____________thru______________ ____________thru______________ ____________thru______________ ____________thru______________ ____________thru______________ ____________thru______________ ____________thru______________ ____________thru______________ List Publication Date __________________ __________________ __________________ __________________ __________________ __________________ __________________ __________________ Sales Invoices and/or Accounts Payable ledger(s) are attached as Exhibits to support the retailer being placed on the published lists. ___________________________________________________ Trade Name of Wholesaler ___________________________________________________ Address ___________________________________________________ Permit Number Phone No. (Notary Seal) _________________________________________________ Wholesaler Representative's Signature ___________________________________________________ Title SWORN TO AND SUBSCRIBED BEFORE ME, the undersigned authority, this the ______day of ___________,_______ ___________________________________________________ Notary Public in and for the State of Texas American LegalNet, Inc. www.FormsWorkFlow.com
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