Application For Alcoholic Beverages License Form - Board Of License Commissioners, Anne Arundel County Maryland Page 4

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BOARD OF LICENSE COMMISSIONERS
FOR ANNE ARUNDEL COUNTY, MARYLAND
APPLICATION FOR ALCOHOLIC BEVERAGES LICENSE CLASS _____________________
STATEMENT OF OWNER OF PREMISES REQUIRED IN CONNECTION WITH
ALCOHOLIC BEVERAGES LAW OF MARYLAND
(I, WE) HEREBY CERTIFY, That (I am, we are) the owner (s) of the property known as ________________________
Named in the aforegoing application made to the State Comptroller under the Alcoholic Beverages Law of Maryland; that
(I, we) hereby authorize the State Comptroller, his duly authorized deputies, inspectors and clerks, the Board of License
Commissioners for Anne Arundel County, 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.
WITNESS (our, my) hand (s) and seal (s) this _____________ day of _________________, ____________.
_______________________________________________ (seal)
_______________________________________________ (seal)
_______________________________________________ (seal)
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) name 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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