Application For Special Event License Page 4
Download a blank fillable Application For Special Event License in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Application For Special Event License with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4SECTION 13
To be completed only by an Officer, Director or Chairperson of the organization named in Section 1.
I,
________________________________________________
declare that I am an Officer, Director or Chairperson of
(Print Full Name)
the organization filing this application as listed in Section 9. I have read the application and the contents and all statements
are true, correct and complete.
X ___________________________________ ___________________________________ _______________ ___________________
Signature
Title/ Position
Date
Phone Number
The foregoing instrument was acknowledged before me this
_______________ ____________________________ _______________
Day
Month
Year
State __________________County of ________________________
___________________
__________________________________________________________
My Commission Expires on:
Date
Signature of Notary Public
SECTION 14
This section is to be completed only by the applicant named in Section 9.
I,
________________________________________________
declare that I am the APPLICANT filing this application
(Print Full Name)
as listed in Section 9. I have read the application and the contents and all statements are true, correct and complete.
X ___________________________________ ___________________________________ _______________ ___________________
Signature
Title/ Position
Date
Phone Number
The foregoing instrument was acknowledged before me this
_______________ ____________________________ _______________
Day
Month
Year
State __________________County of ________________________
___________________
__________________________________________________________
My Commission Expires on:
Date
Signature of Notary Public
Please contact the local governing board for additional application requirements and submission deadlines. Additional
licensing fees may also be required before approval may be granted. For more information, please contact your local
jurisdiction:
SECTION 15
Local Governing Body Approval Section.
I, ____________________________________ _______________________________
recommend
APPROVA
L
DISAPPROVAL
(Government Official)
(Title)
_____________________________, _____________________________, _____________, ______________________
On behalf of
(City, Town, County)
Signature
Date
Phone
SECTION 16
For Department of Liquor Licenses and Control use only.
L
________________________________________________________
APPROVA
DISAPPROVAL
BY:
DATE: ______/______/_______
A.R.S. § 41-1030. Invalidity of rules not made according to this chapter; prohibited agency action; prohibited acts by state
employees; enforcement; notice
B. An agency shall not base a licensing decision in whole or in part on a licensing requirement or condition that is not specifically
authorized by statute, rule or state tribal gaming compact. A general grant of authority in statute does not constitute a basis for imposing a licensing
requirement or condition unless a rule is made pursuant to that general grant of authority that specifically authorizes the requirement or condition.
D. THIS SECTION MAY BE ENFORCED IN A PRIVATE CIVIL ACTION AND RELIEF MAY BE AWARDED AGAINST THE STATE. THE COURT MAY AWARD
REASONABLE ATTORNEY FEES, DAMAGES AND ALL FEES ASSOCIATED WITH THE LICENSE APPLICATION TO A PARTY THAT PREVAILS IN AN ACTION
AGAINST THE STATE FOR A VIOLATION OF THIS SECTION.
E. A STATE EMPLOYEE MAY NOT INTENTIONALLY OR KNOWINGLY VIOLATE THIS SECTION. A VIOLATION OF THIS SECTION IS CAUSE FOR
DISCIPLINARY ACTION OR DISMISSAL PURSUANT TO THE AGENCY'S ADOPTED PERSONNEL POLICY.
F. THIS SECTION DOES NOT ABROGATE THE IMMUNITY PROVIDED BY SECTION 12-820.01 OR 12-820.02.
3/1/2016
Page 4 of 4
Individuals requiring ADA accommodations call (602)542-9027.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business