Form Dbpr Abt-6011 - Application For Caterer'S License (Page 7 of 9) in pdf

Form Dbpr Abt-6011 - Application For Caterer'S License Page 7

SECTION 8 - AFFIDAVIT OF APPLICANT

NOTARIZATION REQUIRED

Trade Name (D/B/A)

"I, the undersigned individually, 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 agree that the place of business,

if licensed, may be inspected and searched during business hours or at any time business is being

conducted on the premises without a search warrant by officers of the Division of Alcoholic Beverages and

Tobacco, agents of the Division of Hotels and Restaurants, the Sheriff, his Deputies, and Police Officers for

the purposes of determining compliance with the beverage law. It is understood that we must maintain for a

period of three (3) years all records required by the division by statute to demonstrate compliance with the

requirements of the purchase of alcoholic beverages and records identifying each customer and the location

and date of each catered event.

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

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

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

qualifications necessary to hold an interest in the alcoholic beverage license."

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

Form Dbpr Abt-6011 - Application For Caterer'S License Page 7