Laserfiche WebLink
-156- <br /> <br />AFFIDAVIT CERTIFYING ANNUAL NON INTOXICATING MALT LIQUOR SALES <br /> OF LESS TH.~N $10,000 ON-SALE ($20,000 OFF-SALE) <br /> <br />As the licensee for <br /> <br />(Name of Establislm~ent) <br /> <br />(Address of Establislunent,) <br /> <br />I hereby state that the 3.2% beer sales were less than St0,000 for the preceding year ($213,000 <br />Off-Sale) <br /> <br />That the named licensee's fiscal year last ended pr/or to this statement began <br />2000 and ended ,2001. <br /> <br />That during that fiscal year, non intoxicating malt liquor sales (3.2% beer sales), whether <br />collected for or not, totaled $ <br /> <br />That during that same fiscal year, purchases of non-intoxicating matt liquor (whether paid <br />for or not during that fiscal year) totaled $ <br /> <br />(Individual Owner) Partnership) (Corporation) <br /> <br />by Signature <br /> <br />Title <br /> <br />Subscribed and sworn to before me this <br /> <br />day of ,2001 <br /> <br />Notary Public <br /> <br />I <br />I <br />I <br />I <br /> <br />I <br />I <br />i' <br />I <br />I <br />I <br />I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br />