Laserfiche WebLink
<br />OPERATOR'S NAME <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />LIST THREE (3) CHARACTER REFERENCES <br /> <br />NAME <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />HAS APPLICANT/OWNER HIS/HER DESIGNEE EVER BEEN CONVICTED OF A CRIME, <br />OTHER THAN A TRAFFIC VIOLATION? <br /> <br />DYES 0 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 />LIST CORPORATE OR P ARTNERSHlP TITLE, IF ANY <br /> <br />CORPORATE OR P ARTNERSHlP ADDRESS: <br /> <br />LIST ALL OFFICERS, MANAGERS OR DIRECTORS, IF CORPORATION: <br /> <br />NAMES <br /> <br />ADDRESS <br /> <br />DATE OF BIRTH <br /> <br />Page 11 of13 <br />