Connecticut > Statewide > Department Of Consumer Protection > Liquor Control Division
Affidavit Of Seller Unpaid Obligations - Connecticut
| Affidavit Of Seller Unpaid Obligations Form. This is a Connecticut form and can be used in Liquor Control Division Department Of Consumer Protection Statewide . |
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AFFIDAVIT OF SELLER UNPAID OBLIGATIONS THIS FORM IS TO BE EXECUTED AT THE TIME OF THE CLOSING THE UNDERSIGNED _______________________________________________________, OF (NAME) ______________________________________________________________, CONNECTICUT, (ADDRESS) BEING DULY SWORN, DEPOSES AND SAYS: 1. 2. I AM OVER THE AGE OF EIGHTEEN YEARS AND BELIEVE IN THE OBLIGATIONS OF AN OATH. I AM THE BACKER, PARTNER OR DULY AUTHORIZED OFFICER IN THE BACKER CORPORATION OF THE LIQUOR PERMIT PREMISES LOCATED AT __________________ __________________________________, CONNECTICUT, PERMIT NUMBER _____________. ATTACHED HERETO AND MADE A PART HEREOF IN EXHIBIT A IS A LISTING OF ALL UNPAID OBLIGATIONS (INVOICES) FOR THE PURCHASE OF ALCOHOLIC LIQUOR AT SAID PERMIT PREMISES PRIOR TO CHANGE IN OWNERSHIP. (IF THERE ARE NONE WRITE THE WORD "NONE".) 3. I, ________________________________________, do hereby swear or affirm that the information herein contained is true to the best of my ability and that I personally completed/directed completion of this form. Signed ______________________________________________________ Date __________________ Personally appeared the signed of the foregoing statement and made oath before me to the truth of the matters contained therein. Signed: _____________________________________________________ (Commissioner of Superior Court, Notary Public, Justice of Peace) Date __________________ American LegalNet, Inc. www.FormsWorkflow.com
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