Cobb County Business License Division P.O. Box 649 Marietta ...
Cobb County Business License Division P.O. Box 649 Marietta ...
Cobb County Business License Division P.O. Box 649 Marietta ...
- No tags were found...
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
<strong>Cobb</strong> <strong>County</strong> <strong>Business</strong> <strong>License</strong> <strong>Division</strong> 16Alcoholic Beverage Establishment Change of <strong>License</strong>e ApplicationRevised 3/10Owner/ <strong>License</strong>e Personal Statement(A photo of applicant must be attached)Attach2x2Picture PhotosHere1. Full name of licensee (Do Not Use Initials) _________________________________________Include maiden name(s), alias(s), etc.2. Social Security No. ____________<strong>Business</strong> Phone___________ Cell Phone_______________3. Home Address: _____________________________________Home Phone_________________4. <strong>Business</strong> Address: ______________________________________________________________5. Race: _______ Sex: ______________ Height: __________________Weight:_______________Age: ________ Color of Hair: ______________Color of Eyes: ___________________________6. Place of Birth: __________________________Date of Birth: ____________________________U.S. Citizen by (please check one): Birth _____ Naturalization _____ Not a citizen _____If naturalized:Certificate #______________Date, place and court: ________________________________ Petition # _________________Derived Parents Certificate #’s_____________________________________________________If not a citizen, please complete the following:Alien Registration #: ________________________ Native Country: ______________________Date and port of entry: __________________________________________________________*MUST PROVIDE ORIGINAL IMMIGRATION DOCUMENTS*7. How long have you resided in the State of Georgia? ___________________________________8. Number of years resided at your present address? _____________________________________9. What has been your occupation for the past five (5) years?______________________________10. What is your position title with the business submitting this license application? __________________________________________________________________________________________11. Are you: (Circle one)Single Married Widowed Divorced Separated
Change language