Form Com/att-009 - Application For A Class Beer, Wine And Liquor License Page 2

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3. Usual physical location where boat is housed (dock, wharf, pier, etc.):

(if applicable)

4. Boat Name (if applicable)

5. Business Phone Number(s)

Fax Number

E-mail address

6. a. Date business began

b. Type of accounting period (Calendar Year, Fiscal Year, etc.)

Month FY begins

c. If Corporation or Limited Liability Company - date chartered

State

d. Federal Employer Identification No.

7. The name and address of the owner of the boat, plane, or train

8. The applicant is presently the holder of the following alcoholic beverage licenses or permits issued by Maryland, any other state or jurisdiction,

or the United States government (if more space is needed, attach additional sheet).

Issuing Authority

Type

Expiration Date

Number

9. The applicant has previously held the following alcoholic beverage licenses or permit:

10. The applicant has applications pending for the following alcoholic beverage licenses or permits:

11. Please answer each of the following questions: (attach explanation if “Yes” to “*” questions)

G Yes

G No

*A.

Has any applicant ever been convicted of a felony by any State or Federal Court?.......................................

*B.

Has any applicant ever been convicted of a violation of the laws of the United States, Maryland or any other

G Yes

G No

state concerning alcoholic beverages gaming or gambling?............................................................................

G Yes

G No

*C.

Has any applicant ever been denied or had revoked an alcoholic beverage license or permit?.....................

*D.

Do any of the applicants or their immediate families have an interest in a Maryland wholesale or retail alcoholic

G Yes

G No

beverage license, either issued or applied for?................................................................................

Do the applicants agree to conform to all the laws, rules, and regulations of the state of Maryland relating to

G Yes

G No

the business in which they propose to engage under this license?.................................................................

The applicants submit herewith a statement duly executed and acknowledged by the company on whose

behalf the license is desired, assenting to the granting to the license applied for, authorizing the comptroller,

his duly authorized deputies, inspectors and clerks, to inspect and search, without warrant, any and all

airplanes, cars, or boats to which such license applies, at any and all hours, provided no such inspection or

search shall be made at such time or in such manner as to delay or interfere with movement of any airplane,

G Yes

G No

train, or boat. .................................................................................................................................................

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