Application For Alcoholic Beverages License Form - Board Of License Commissioners, Anne Arundel County Maryland Page 2
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4BOARD OF LICENSE COMMISSIONERS
FOR ANNE ARUNDEL COUNTY, MARYLAND
APPLICATION FOR ALCOHOLIC BEVERAGES LICENSE CLASS _____________________
14. The applicant (s) (has, have) not been adjudged guilty of any offense against the laws of the State or of the United States.
True
False
15. No manufacturer, brewer, distiller, or wholesaler, directly or indirectly, has any financial interest in the premises or
business of the applicant.
True
False
16. The applicant (s) will not convey or grant to any manufacturer, brewer, distiller, or wholesaler any financial interest,
except as otherwise permitted in Article 2B.
True
False
17. The applicant (s) (has, have) at the time of filing this application no indebtedness or other financial obligation and will
not incur any such indebtedness or other financial obligation, directly or indirectly, to any manufacturer, brewer,
distiller or wholesaler other than for the purchase of alcoholic beverages.
True
False
18. The applicant (s) will, if granted a license, conform to all laws and regulations relating to the business in which the
applicant (s) propose (s) to engage.
True
False
19. The applicant (s) submit (s) herewith a statement duly executed and acknowledged by the owner of the premises in
which the business is to be conducted, assenting to the granting of the license applied for, authorized the Comptroller,
his duly authorized deputies, inspectors and clerks, the Board of License Commissioners of the county in which the place
of business is located, its duly authorized agents and employees, and any peace officer of such county, to inspect and
search, without warrant, the premises upon which the business is to be conducted, and any and all parts of the building
in which said business is to be conducted, at any and all hours.
True
False
EXTRACT FROM LAW: If any affidavit or oath required under the provisions of the Act shall contain any false
statement, the offender shall be deemed guilty of perjury, and upon indictment and conviction thereof, shall be
subject to the penalties provided by law for that crime.
Give name (s), title (s), and address (es) of applicants:
(name)
(title)
(home address)
(name)
(title)
(home address)
(name)
(title)
(home address)
*Note: If President or Vice-President is one of the applicants,
*1.________________________________________
he/she must also sign as an applicant.
(signature of President or Vice President
1.________________________________________
(signature of applicant)
(Corporate Seal)
2. _______________________________________
(signature of applicant)
3. _______________________________________
(signature of applicant)
STATE OF MARYLAND _______________________________________________________________________ as:
THIS CERTIFIES, That on the ___________day of _______________, ________, before the subscriber, a
_____________________________ of the State of Maryland, personally appeared _____________________
_____________________________ the applicant (s) named in the foregoing application, and made oath in due
form of law that the statements therein are true to the best of (his, their) knowledge and belief.
WITNESS my hand and notary seal
_____________________________________
(NOTARY PUBLIC)
(SEAL)
_________________________________________________________________________________________________
P a g e
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