Cobb County Business License Division 1 New Alcoholic Beverage ...
Cobb County Business License Division 1 New Alcoholic Beverage ...
Cobb County Business License Division 1 New Alcoholic Beverage ...
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<strong>Cobb</strong> <strong>County</strong> <strong>Business</strong> <strong>License</strong> <strong>Division</strong> 10<strong>New</strong> <strong>Alcoholic</strong> <strong>Beverage</strong> Establishment ApplicationRevised 3/1010. Does the licensee, partner, member, manager, corporation, stockholder in the corporation, orany owner have any other vested interest in any other alcoholic beverage license in the Stateof Georgia? Yes ( ) No ( )If yes, give complete name(s), address, and phone number(s) below.____________________________________________________________________________________________________________________________________________________________________________________________________________________________________11. List full name, date of birth, social security number, address, and percentage of ownership for eachindividual, including all “limited” and “silent” partners, having any vested interest in this application.(Attach any document indicating ownership, direct, indirect, or by default.)Name DOB SSN Address % of Ownership_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________12. List full name, address, and percentage of ownership for each firm or corporation having anyinterest in this application.Corporate Name <strong>Business</strong> Address % Owned_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________13. List full name, position held, social security number, address, and percentage of ownership for eachboard member of each corporation.Name Position Held SSN Resident Address % Owned___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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