Agenda - Council - 12/15/1998 - Laserfiche WebLink

Home

FINANCIAL DISCLOSURE STATEMENT On-Sale Liquor License (Intoxicating) State hah names, residences, business addresses and telephone numbers of the owner or owners of the building wherein the licensed business will be located, if the owner is other than the applicant (if other than new construction). II. Where the building is owned by other than applicant, state in summary the conditions of the 1ease arrangement, such as, term of lease, monthly rental, renewal privileges, etc. III. If the building is owned by the individual applicant, partnership, corporation, or association, state: A) Date purchased (or planned completion date for new construction). B) If new construction, total cost of the building and method of financing such cost. 1) If financed by mortgage, name and address of mortgage holder. 2) If contract for deed, name and address of holder of such contract for deed. 3) Rate of interest on mortgage or contract for deed. 4) Monthly payment for liquidation of mortgage and/or contract for deed. State the total cost of assets acquired to start this business including the business premises, if purchased, fixtures, furniture, equipment, merchandise for resale, cash for working capital, prepaid insurance, and any other assets. A) Of the above costs of assets acquired, state the amount that is provided by the person(s) investing in this business (attach proof of the source of such money). Give full names, addresses, telephone numbers of ali persons, other than the applicant, who have any financial interest in the business, buildings, premises, fixtures, furniture, or stock in trade. State the nature of the interest amount thereof, and the terms for payment or other reimbursement (this shah include, but not be limited to, any leasees, lessors, mortgagors, mortgagees, lendees, lien holders, trustees, trustors and persons who have cosigned notes or otherwise loaned, pledged or extended security for any indebtedness of the applicant). Nature of ~terest: ~~ ~ ~ ' 0 ~ Phone Number: ~-0l~ I I ! I Full Name: Address: Nature of Interest: Phone Number: