Form Dbpr Abt-6034 - Application For Bottle Club License And Retail Tobacco Products Dealer Permit Page 2
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14SECTION 3 – LICENSE INFORMATION
**If this application is for a New license or permit, the following questions are not applicable.
Current Business Name
Current License Number
Is the transfer of this license due to revocation proceedings?
Yes
No
If yes, is there any personal relationship to the transferor?
Yes
No
If yes, explain the relationship:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
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Parent category: Legal