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Los Lunas Liquor License Application

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Los Lunas Liquor License Application Powered By Docstoc
					                          Village of Los Lunas
                     Liquor License Application Form

                 LICENSE FEE OF $200.00 IS DUE JULY 1

                      Initial ______          Renewal ______

NAME OF BUSINESS:____________________________________________________________

MAILING ADDRESS:___________________________________________________

BUSINESS ADDRESS:__________________________________________________

APPLICANT IS: Individual________ Partnership_______ Corporation ________

   A. For Individuals – Name and Address of Owner:




   B. For Partnerships – Names and Addresses of All General Partners:

   __________________________________________________________________________________

   For Corporations – Names and Addresses of Officers:

   President: _________________________________________________________________________

   Vice President:
   __________________________________________________________________________________
   Secretary:

   Treasure:__

Current New Mexico Alcohol Division Receipt Number:______________________________________

Current NM Revenue Division ID Number:_________________________________________________

NAME OF CORPORATION, PARTNERSHIP OR OTHER ENTITY
BY___________________________________________________________________________________

______________________________________________________________________________________
PRINT NAME
______________________________________________________________________________________
OFFICE OR POSITION HELD


Dated:__________, 20_____


______________________________________________________________________________________
FOR VILLAGE USE ONLY:

DATE RECEIVED:________________________________
RECEIPT NO:____________________________________
LICENSE NO.____________________________________
CHECKED BY: ___________________________________

				
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