Creditor'S Affidavit Form - City Of Independence, Missouri Finance Department

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CITY OF INDEPENDENCE, MISSOURI
Finance Department - License Division
111 East Maple
Independence, Missouri 64050
816-325-7079
CREDITOR'S AFFIDAVIT
Date
I (we),
,
seller of the business known as
do hereby affirm that I (we) have no outstanding liquor bills to any wholesaler, or I (we) have notified all wholesalers
to whom I (we) owe money of my (our) intent to sell the business.
Signature
Signature
Signature
Signature
Subscribed and sworn to before me this
day of
,20
.
Notary Public
My Commission expires:

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