Cobb County Business License Division P.O. Box 649 Marietta ...

Cobb County Business License Division 6Alcoholic Beverage Establishment Change of Licensee ApplicationRevised 3/103. Mailing Address: ______________________________________________________________City: ______________________________, State: __________________Zip: ______________Email Address: _________________________________4. Licensee Full Name _____________________________________Title: ___________________SS # ______-____-_____ Business Phone: _________________ Home Phone _____________Home Address _________________________________________________________________City: _____________________________, State: ____________________Zip: ______________5. Type of Ownership: Sole Proprietor ( ) Partnership ( ) Corporation ( )LLP ( ) LLC ( )6. If Sole Proprietor - Owner’s Name: ________________________________________________SS# _____-____-_____ Date of Birth: _____________________________Home Address: _______________________________________Home Phone: ______________City: ____________________________, State: ____________________Zip: _______________7. If Partnership or Limited Liability PartnershipPartnership or LLP Name: ________________________________________________________Name of Partner/Member: ___________________________________SS#______-____-_____Date of Birth: ___________________________ Percentage of Ownership: ________________Home Address: ______________________________________Home Phone:_______________City: __________________________, State: _____________________Zip: _______________Name of Partner/Member: ___________________________________SS#______-____-_____Date of Birth: ___________________________ Percentage of Ownership: ________________Home Address: ______________________________________Home Phone:_______________City: __________________________, State: _____________________Zip: _______________* Include additional partners/members on separate attachment*