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I <br />I <br />I <br /> <br />I have no intention or agreement to transfer the license to another person. <br /> <br />I submit the following names of persons, including a bank, for reference, with whom I have had business relations as follows: <br /> <br /> ! <br /> <br /> I <br /> I <br /> I <br /> I <br /> I <br />'1 <br /> I <br /> i <br /> <br /> I <br /> ! <br /> <br />i <br />! <br />I <br /> <br />I do not possess and will not purchase a $25.00 Federal Retail Liquor Dealers Special Stamp. <br />I intend to engage in the sale of intoxicating liquor and will have a Federal Occupation Tax Receipt in <br />accordance with the ordinance governing this license. My Federal Tax Stamp Receipt is No. <br />I will comply strictly with the provisions of the ordinance relating to the sale of sof~ drinks for ~mixing" purposes and will serve <br />patrons in full view of public. <br />I agree to waive my Constitutional Rights against search and seizure and will freely permit peace officers to inspect my premises <br />and agree to the forfeiture of my license if found to have violated the provisions of the ordinance (resolution) providing for the <br />granting of this license. <br />I hereby solemnly swear that the foregoing statements are true and correct to the best of my knowledge and that I agree to <br />comply with all the provisions of the ordinance under which this license is granted. <br /> / /_ <br />Subscribed and sworn to before me this '7/,/ /TM aayof-~ ' ~_',,._~,'x/ 199 <br /> / ' <br /> / / <br /> <br />Note- Laws 1949, Chapter 700, provides that applicant must have attained the age of 21 years and must be the proprietor of the <br />establishment where such business is to be conducted. <br /> <br /> <br />