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I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> I <br /> I <br />I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> <br />I have never been convicted of a felony nor of vio{ating any National or state liquor law or local <br />ordinance relating to the manufacture, sale or transportation, or possession for sale or <br />transportation of intoxicating liquor. <br />Gambling or gambling devices will not be pemtitted on the licensed premises. <br /> <br />~ am the owner of the leasehold, furniture fixtures, and equipment in the premises for which the <br />license is applied, except <br /> <br />I have no intention or agreement to transfer the license to another person. <br /> <br />I submit the following names o£persons, including a bank, for reference, witlx whom I have had <br />business relations as follows: ' ' <br /> <br />I do not possess and will not purchase a $25.00 Federal Retail Liquor Dealers Special Stump. <br />I /'~o /2..o~.. intend to engage in the sate of intoxicating liquor and will have a Federal <br />Occupation Tax Receipt in accordance with the ordinance goverrfing this license. My Federal <br />Tax Stamp Receipt is No. <br /> <br />I will compiy strictly with the previsions of the ordinance relating 1o the sale of soft drinks for <br />"mixing" purposes and will serve patrons in full view of public. <br />I agree to waive rny Constitutional Rights against search and ~eizure and will freely permit peace <br />officers to inspect my premises and agree to the forfeiture oi' my license if foun~d to have violated <br />the provisions of the ordinance (resolution) providing for the granting of this license. <br />I hereby solmmfly swear that the foregoing statements are true and correct to the best of my <br />knowledge and that I agree te comply with ali' the provisions of the ordinance under which this <br />license is granted. <br /> <br />Subscribed and sworn to bel'bre me this day of ~'e~ ¢ 200 <br /> <br />Note-Laws 1949~ Chapter 700, provides that applican, t must have attained the age of 21 years <br />must be the proprietor of th~' establishment where such business is to be conducted. <br /> <br />-167- <br /> <br /> <br />