Nebraska > Statewide > Liquor Control Commission
Application For Liquor License Partnership Insert-Form 2 (Shipper License) 35-4184shpr - Nebraska
| Application For Liquor License Partnership Insert-Form 2 (Shipper License) Form. This is a Nebraska form and can be used in Liquor Control Commission Statewide . |
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APPLICATION FOR LIQUOR LICENSE PARTNERSHIP INSERT FORM 2 NEBRASKA LIQUOR CONTROL COMMISSION 301 CENTENNIAL MALL SOUTH PO BOX 95046 LINCOLN, NE 68509-5046 PHONE: (402) 471-2571 FAX: (402) 471-2814 Website: www.lcc.ne.gov SHIPPER LICENSE Name of Partner: Last Name_______________________________________________________________ First Name__________________________________________ MI _________________ Home Address___________________________________City_____________________ Home Telephone Number___________________________________________________ Social Security Number_______________________Date of Birth___________________ Name of Partner: Last Name_______________________________________________________________ First Name__________________________________________ MI _________________ Home Address___________________________________City_____________________ Home Telephone Number___________________________________________________ Social Security Number_______________________Date of Birth___________________ FORM 35-4182-ship REV. 2/05 American LegalNet, Inc. www.FormsWorkflow.com
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