Trust Stipulation For Retail Applicants - New York State Liquor Authority Page 2

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Trust Stipulation for Retail Applicants
230
Trust Disclosure Form
Applicant Name:
Serial Number:
Name of Irrevocable Trust:
Names of Grantors:
1
Names of Trustees
:
Please provide/attach an organizational chart to show applicant company and any other entities with a financial
interest.
1
The trustees will each be required to complete a personal questionnaire and be listed as principals on the license, unless
there are more than ten shareholders and the trust owns less than ten percent of the company or corporation applying for the
liquor license.” The failure to provide detailed information as requested may result in a significant delay, or ultimately the
disapproval, of an application.
Trust Stipulation Retail – rev. 032817

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