LIQUOR LICENSE APPLICATION
(Type or Print Everything Except Signatures)
HOLLAND, MICHIGAN
DATE
I/We hereby make application for:
o
TRANSFER OF OWNERSHIP OF
license(s) located at
(Type)
(Address of Establishment)
from
who resides at
(Name of Present Owner)
(Home Address of Present Owner)
o
TRANSFER OF LOCATION OF
license(s) from
(Type)
(Present Address of Establishment)
to
(Proposed Address of Establishment)
o
NEW
license to be located at
(Type)
(Proposed Address of Establishment)
o
CONVERSION of license from
to
for business located at
(Type)
(Type)
(Address of Establishment)
The business is, or will be known as,
(Name of Establishment)
and respectfully request that said license(s) be issued in the name(s) of
as:
an INDIVIDUAL
(Give name and home address below)
a PARTNERSHIP
(List below name, address, and percentage of ownership of each partner)
a CLUB*
(List below names, titles and home addresses of three officers, authorized agent,
CORPORATION** and person responsible for management of license)
(Name)
(% Ownership of Title)
(Home Address)
(Name)
(% Ownership of Title)
(Home Address)
(Name)
(% Ownership of Title)
(Home Address)
(Name)
(% Ownership of Title)
(Home Address)
(Name)
(% Ownership of Title)
(Home Address)
* IF APPLICANT IS A CLUB: When organized?
Has it been in existence continuously since
being organized