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CC_Minutes_2013_1118
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CC_Minutes_2013_1118
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Last modified
12/17/2013 9:45:31 AM
Creation date
11/26/2013 11:00:14 AM
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Roseville City Council
Document Type
Council Minutes
Meeting Date
11/18/2013
Meeting Type
Regular
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Page 7 PLEASE TYPE OR PRINT ALL INFORMATION <br /> STATE ASSIGNED LICENSE NUMBER 0252 - 44 005 003 <br /> ALL APPLICANTS OTHER THAN CLUB LICENSE ANSWER THE FOLLOWING <br /> 7.1 DOES THE APPLICANT,A MEMBER OF THE APPLICANT'S IMMEDIATE FAMILY(SPOUSE, CHILDREN, <br /> PARENTS, IN-LAWS OR SIBLINGS)OR ANY PERSON WITH A BENEFICIAL INTEREST IN THE SUBJECT <br /> LICENSE OF THIS APPLICATION, HAVE ANY INTEREST IN ANY OTHER NEW JERSEY ALCOHOLIC <br /> BEVERAGE LICENSE? <br /> XX Yes No <br /> IF THE ANSWER IS "YES," COMPLETE THE FOLLOWING BY LISTING THE NEW JERSEY LIQUOR <br /> LICENSE TWELVE DIGIT NUMBER(S) AND THE NAME(S) OF THE PERSON(S) OR CORPORATION(S) <br /> WHO HOLD(S) SUCH INTEREST. USE ADDITIONAL PAGE(S)7 AS NEEDED. <br /> A. License Number 0409 44 _ 001 _ 006 <br /> Name Cherry Hill Wine and Spirits Inc, <br /> (Last Name, First Name, Middle Initial or Corporate Name) <br /> Relationship to Applicant Brother <br /> ***************************** ***********irlt************F**,r*w+r*lrafk,r+r****r*,t,t+.l*****#-1************t*lF********t*** <br /> B. License Number 2019 _44 _ 071 _ 005 <br /> Name Cherry Hill Wine And Spirits Inc. <br /> (Last Name, First Name, Middle initial or Corporate Name) <br /> Relationship to Applicant Brother <br /> C. License Number 0722 - 44 - 046 - 008 <br /> Name E.G. Holding Corporation, Inc. <br /> (Last Name, First Name, Middle Initial or Corporate Name) <br /> Relationship to Applicant Self — Robert Trone <br /> **************************************************************************************************************** <br /> 7.2 WOULD ANY PERSON OR CORPORATION NAMED IN THIS APPLICATION FAIL TO QUALIFY FOR <br /> OWNERSHIP OF THE LICENSE IF APPLYING AS AN INDIVIDUAL BECAUSE OF AGE, CRIMINAL <br /> CONVICTION OR PROHIBITED INTERESTS IN OTHER LICENSES? <br /> XX <br /> Yes No <br /> IF THE ANSWER IS"YES,"ANSWER THE FOLLOWING BY INSERTING THE NAME OF THE INDIVIDUAL <br /> OR CORPORATION AND THE SOCIAL SECURITY NUMBER AND DATE OF BIRTH,IF AN INDIVIDUAL.USE <br /> ADDITIONAL PAGE(S)7 AS NEEDED. <br /> Name _ <br /> (Last Name, First Name, Middle Initial or Corporate Name) <br /> Social Security Number - - OR <br /> NJ Sales Tax Certificate of Authority No. <br /> -Date of Birth / / <br />
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