Form Dbpr Abt-6008 - Application For Importer Or Broker Sales Agent (Page 6 of 7) in pdf

SECTION 7 - AFFIDAVIT OF APPLICANT

NOTARIZATION REQUIRED

Trade Name (D/B/A)

"I, the undersigned individual, or if a corporation for itself, its officers and directors, hereby swear or affirm that I

am duly authorized to make the above and foregoing application and, as such, hereby acknowledge that

access must be provided to authorized employees of the division to all business premises and records.

I swear under oath or affirmation under penalty of perjury as provided in Sections 559.791, 562.45 and 837.06,

Florida Statutes, that the foregoing information is true and correct and that no other person or entity except as

indicated herein has an interest in the business and that all of the above listed persons or entities meet the

necessary qualifications to be licensed as an Importer, Broker, or Sales Agent."

STATE OF___________________

_________________________________________________

APPLICANT SIGNATURE

COUNTY OF_________________

_________________________________________________

APPLICANT SIGNATURE

The foregoing was ( ) Sworn to and Subscribed OR ( ) Acknowledged Before me this ______ Day

of______________, 20_____, By_________________________________ who is ( ) personally known to

me OR ( ) who produced ______________________________________________as identification.

________________________________________________ Commission Expires: ___________________

Notary Public

SECTION 8 - AFFIDAVIT OF TRANSFEROR

NOTARIZATION REQUIRED

Trade Name (D/B/A)

"I, the undersigned, hereby swear or affirm that I am duly authorized to make this affidavit and do hereby

consent, on my behalf or on behalf of the transferor, to the above transfer, and represent to the Division of

Alcoholic Beverages and Tobacco that the license which is being transferred is as shown in the application

and that a bona fide sale in good faith has been made to the within applicant of the business for which the

foregoing transfer of license is sought."

STATE OF___________________

_________________________________________________

TRANSFEROR OR AUTHORIZED OFFICER SIGNATURE

COUNTY OF_________________

_________________________________________________

TRANSFEROR OR AUTHORIZED OFFICER SIGNATURE

The foregoing was ( ) Sworn to and Subscribed OR ( ) Acknowledged Before me this ______ Day

of______________, 20_____, By_________________________________ who is ( ) personally known to

Me OR ( ) who produced ______________________________________________as identification.

________________________________________________ Commission Expires: ___________________

Notary Public

FOR DIVISION USE ONLY

Form Dbpr Abt-6008 - Application For Importer Or Broker Sales Agent Page 6