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Affidavit Of Financial Loan LIQ 819-50 - Washington
| Affidavit Of Financial Loan Form. This is a Washington form and can be used in Financial Liquor Control Board Statewide . |
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Licensing and Regulation Division PO Box 43098 Olympia WA 98504-3098 Phone: (360) 664-1600 FAX: (360) 753-2710 www.liq.wa.gov __________________________________________________ Trade Name __________________________________________________ License Number __________________________________________________ UBI Number Affidavit of Financial Loan This affidavit serves to provide information to the Washington State Liquor Control Board regarding the review of a liquor license application (RCW 66.08.140). The below named financial institution has completed this form and given final approval of a financial loan for: Name of Person(s) or Entity Approved for Loan: _________________________________ __________________________________________________________________________ Loan or Account Number: ___________________________________________________ Amount of Loan: ___________________________________________________________ Repayment Plan (to include balloon payments and interest percentage): ____________ __________________________________________________________________________ __________________________________________________________________________ Collateral or Security: _______________________________________________________ Date Loan was finalized: ____________________________________________________ _________________________________ Financial Institution Name _________________________________ Phone Number of Representative _________________________________ Authorized Signature/Title ________________________________ Print name _________________________________ Date LIQ 819-50-4/07 American LegalNet, Inc. www.FormsWorkFlow.com
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