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<br /> <br /> <br />LIST THREE (3) CHARACTER REFERENCES <br /> <br />NAME ADDRESS PHONE <br /> <br /> <br /> <br /> <br /> <br /> <br />HAS APPLICANT/OWNER HIS/HER DESIGNEE EVER BEEN CONVICTED OF A CRIME, <br />OTHER THAN A TRAFFIC VIOLATION? <br /> <br />?? <br /> YES NO <br /> <br />IF YES, GIVE EXPLANATION ON A SEPARATE SHEET OF PAPER, INCLUDING TIME, <br />PLACE AND NATURE OF EACH CRIME OR OFFENSE AND DISPOSITION THEREOF. <br /> <br />LIST ALL CREDITORS INVOLVED IN THE CONSTRUCTION AND MAINTENANCE IN ANY <br />WAY PROVIDING DEBT OF EQUITY FINANCING TO SAID OPERATION: <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />LIST CORPORATE OR PARTNERSHIP TITLE, IF ANY <br /> <br />CORPORATE OR PARTNERSHIP ADDRESS: <br /> <br />LIST ALL OFFICERS, MANAGERS OR DIRECTORS, IF CORPORATION: <br /> <br />NAMES ADDRESS DATE OF BIRTH <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />Please submit accurate and complete business records showing names and addresses of all individuals <br />having an interest in business including partners, officers, owners and creditors furnishing credit for <br />establishment acquisition and maintenance and furnishing of said business. <br /> <br />Please furnish accurate documentation establishing the interest of the applicant and any other person <br />having interest in the premises upon which the building is proposed to be located or furnished thereof. <br />The documentation shall be in the form of a lease, deed, contract for deed, mortgage deed, etc. and any <br />