Creditors Affidavit
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Creditors Affidavit Form. This is a Alaska form and can be use in Alcoholic Beverage Control Board Statewide.
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Tags: Creditors Affidavit, Alaska Statewide, Alcoholic Beverage Control Board
STATE OF ALASKA
ALCOHOLIC BEVERAGE CONTROL BOARD
CREDITORS AFFIDAVIT AS 04.11.280 AND AS 04.11.360
AFFIDAVIT
I/We
being first duly sworn on oath, depose
and state that I/we am/are the licensee(s) and transferor(s) of that certain business known as
located at
in connection with liquor license
number
and that the following is a listing of accounts payable and taxes owed by the
above licensed business as of
.
Creditor/Taxing Authority
Complete Mailing Address
Amount
SIGNED
SIGNED
SIGNED
Purpose of Liability
SIGNED
Subscribed & sworn to before me this
day of
20
Notary Public in & for Alaska
My commission expires
(Rev. 5/2001)
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