Form Com/att7-1 - Application For Change In License Location

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Comptroller of Maryland
MATT Regulatory Division
Alcohol and Tobacco Tax
P. O. Box 2999
Louis L. Goldstein Treasury Building
Annapolis, Maryland 21404-2999
Application for Change in License Location
(Note: Application must be approved prior to move)
This statement is to be attached to and made a part of the application of:
Name(s) of license applicant(s)
License Number
Whose trade name is _____________________________________________________________________________________
Whose present location is __________________________________________________________________________________
(number and street - town - county - zip code - other description)
The NEW location for which license transfer is desired is known as: _________________________________________________
Fully describe premises ____________________________________________________________________________________
Telephone number
Fax number ________________________________________
Date of anticipated move
I do solemnly declare and affirm under the penalties of perjury that the contents of the foregoing documents are true and
correct to the best of my knowledge, information and belief.
Signature of owner, partner or corporate officer
Type or print name of owner, partner or corporate officer
Statement of Owner of Premises Required in Connection with Alcoholic Beverages Law of Maryland
(I, We) hereby certify, that (I am, we are) the owner(s) of property known as
named in the aforegoing application made to the Comptroller of Maryland under the Alcoholic Beverages Law of Maryland; that (I,
we) assent to the granting of the license applied for, and that (I, we) hereby authorize the Comptroller of Maryland, his duly
authorized deputies, inspectors and clerks, the Board of License Commissioners of the county in which the place of business is
located, its duly authorized agents and employees, and any peace office of such county to inspect and search, without warrant, the
premises upon which the business is to be conducted, and any and all parts of the building(s) in which said business is to be
conducted, at any and all hours.
Owner’s signature
Type or print name of owner
Rev. 07/07


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Parent category: Financial