Form Airport - Public Airport All-Beverages License Application Page 2
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4Section 3. Corporate Statement
All entities, except sole proprietorships, must provide the following information for all shareholders, members or partners
(please include additional pages if necessary).
1
Name
SSN
Address
Date of Birth
Percentage of Ownership (for corporations, also include number of shares)
2
Name
SSN
Address
Date of Birth
Percentage of Ownership (for corporations, also include number of shares)
3
Name
SSN
Address
Date of Birth
Percentage of Ownership (for corporations, also include number of shares)
4
Name
SSN
Address
Date of Birth
Percentage of Ownership (for corporations, also include number of shares)
Officers and Directors
Name
Address
Title
Public Airport All-Beverages License Application
Page 2
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Parent category: Financial