Cache County Alcohol License Application (Page 4 of 4) in pdf

Cache County Alcohol License Application Page 4

CACHE COUNTY

AFFIDAVIT FOR ALCOHOL LICENSE APPLICATION

A SIGNED AFFIDAVIT IS REQUIRED FOR EACH APPLICANT,

PARTNER, DIRECTOR, MANAGER, OFFICER, AND STOCKHOLDER LISTED ON THE APPLICATION

Business Name: ___________________________________________________________________________

STATE OF UTAH

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COUNTY OF CACHE

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I, ___________________________________________, being duly sworn, depose and say under

penalty of perjury, that I am the applicant above-named, and I hereby attest that the above information is true

and correct to the best of my knowledge. I understand that falsifying this application is grounds for denial or

revocation of my license(s).

I know and understand the state law and Cache County Ordinances governing the sale and consumption of

alcohol and will obey all laws as they pertain to my business license.

I certify that I have not been convicted of a felony under any federal or state law and have not been convicted of

any crime concerning sale, distribution, or transportation of alcoholic products or any crime of moral turpitude.

I agree and give my consent to the Cache County Sheriff’s Office to complete a criminal history/warrant

background check on the applicant(s) as part of the application process.

________________________________________

Applicant Signature

SUBSCRIBED AND SWORN to before me this ______ day of _________________________, 20___

________________________________________

NOTARY PUBLIC

Cache County Alcohol License Application Page 4