Application For Liquor License Type Or Print With Black Ink - Arizona Department Of Liquor Licenses And Control Page 6

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SECTION 14 SIGNATURE BLOCK
NOTARY
I
______________________________________________ hereby declare that I am the Individual Agent, Owner,
(Print Full Name)
Or Controlling Person on the stated license and location.
Signature: _________________________________________ State of _________________ County of _______________________
The foregoing instrument was acknowledged before me this
My Commission Expires on: __________________________
___________ Day of ___________________, ____________
Date
Day
Month
Year
__________________________________________________
Signature of Notary
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.
1/11/2018
page 6 of 6
Individuals requiring ADA accommodations please call (602)542-2999

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