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Aurora%20Consent%20to%20Release%20Financial%20Information

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					                                                                                                             City of Aurora
                                                                                            Licensing Section, Suite #1100
                                                                                               15151 E. Alameda Parkway
                                                                                                       Aurora, CO 80012
                                                                                                            303-739-7057
                                                                                                       www.auroragov.org

                             CONSENT TO RELEASE FINANCIAL INFORMATION
                                                                                                             Reviewed 1-9-2012

TO WHOM IT MAY CONCERN, WHEREAS, application for a
  New
  Change of Location
  Change in Type of License
  Change of Ownership
  Change in Corporate Structure for a ______________________________________ has been submitted by:
                                                               (Type of License)

__________________________________________________________________________________________
                                      (Corporation/Partnership/LLC/Sole Proprietor)

dba_______________________________________________________________________________________
                                                     (Trade name)

and I,_____________________________________________________________________________________
                                                   (Applicant’s Name)

am associated with said applicant in the capacity of ________________________________________________
                                                                                      (Title)
and fully understand that an investigation of my credit standing and business reputation is necessary for the
approval of said license.

NOW, THEREFORE, I hereby consent to, and authorize the release of any and all business books, records,
check books, bank statements and records, financial data, balance sheets, income accounts, forms, and all other
applicable data and information relative to my credit standing and business reputation by any person or entity
having possession or control thereof to any person presenting a signed copy thereof, upon the express condition,
however, that said release is limited to an investigation conducted pursuant to the aforesaid licensing and
operation, but this consent shall continue to operate so long as the above-named licensee shall hold said license,
if granted, and for the term or terms of any renewals or extension thereof.


__________________________________________________________________________________________
Signature and Title of Applicant                           Date of Signature

State of ___________________________)
                                     §
County of __________________________)

Subscribed and sworn to before me this _______ day of _____________________________, 20______, by

______________________________________________.

______________________________________________
Notary Public
                                                                                                SEAL
______________________________________________
Address

My Commission Expires:__________________________

				
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