Cache County Alcohol License Application Page 2
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4EACH APPLICANT LISTED IN THE FOLLOWING SECTION MUST BE OVER 21 YEARS OF AGE,
A CITIZEN OF THE UNITED STATES AND A CITIZEN OF THE STATE OF UTAH
Applicant Information:
Full Name: _______________________________________ DOB: _____________ SSN: ________________
Phone #: _____________________ Driver License #: ___________________________ State: ___________
Address: __________________________________________________________________________________
Mailing Address: ___________________________________________________________________________
Other partners, managers, directors, officers, and/or stockholders:
Full Name: _______________________________________ DOB: _____________ SSN: ________________
Address: __________________________________________________________________________________
Full Name: _______________________________________ DOB: _____________ SSN: ________________
Address: __________________________________________________________________________________
Full Name: _______________________________________ DOB: _____________ SSN: ________________
Address: __________________________________________________________________________________
Full Name: _______________________________________ DOB: _____________ SSN: ________________
Address: __________________________________________________________________________________
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