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Affiliation Agreement DLC 4255 - Ohio
| Affiliation Agreement Form. This is a Ohio form and can be used in Division Of Liquor Control Department Of Commerce Statewide . |
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State of Ohio Division of Liquor Control 6606 Tussing Road Reynoldsburg, OH 43068-9005 (614) 644-2431 FAX (614) 728-1283 http://www.com.state.oh.us AFFILIATION AGREEMENT THIS FORM WILL BE RETURNED IF IT IS NOT COMPLETED ENTIRELY, AND SIGNED BY BOTH THE HOTEL OFFICER AND PERMIT HOLDER. This is to certify that ___________________________________, and _____________________________ (HOTEL) (PERMIT HOLDER) are affiliated. The _____________________________ will serve liquor to the hotel guests upon request during all hours (PERMIT HOLDER) of legal operation. Furthermore, _______________________________ approves the affiliation agreement, (HOTEL) in terms of processing the D5A liquor license. However the ____________________________________, (PERMIT HOLDER) will assume all liability. HOTEL OFFICER: _____________________________________ ________________________________ (SIGNATURE (TITLE) ______________ (DATE) PERMIT HOLDER: _____________________________________ ________________________________ (SIGNATURE (TITLE) ______________ (DATE) DLC4255 EOE/ADA PROVIDER FOR TTY USERS DIAL ORS 1-800-750-0750 REV. 12-05 American LegalNet, Inc. www.FormsWorkflow.com
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