Restaurant Or Eating Place Statement In Support Of Renewal
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Restaurant Or Eating Place Statement In Support Of Renewal Form. This is a Alaska form and can be use in Alcoholic Beverage Control Board Statewide.
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Tags: Restaurant Or Eating Place Statement In Support Of Renewal, Alaska Statewide, Alcoholic Beverage Control Board
Alcoholic Beverage Control Board
550 W. 7th Avenue, Suite 350
Anchorage, Alaska 99501
907 269-0350
Fax 907 272-9412
Restaurant or Eating Place
Statement in support of Renewal of Liquor License issued under
AS 04.11.100
License # ______________
Name of licensed premises: _____________________________
Gross receipts from the sale of food at the above licensed premises
constituted at least 50 percent of the gross receipts of the business
during the ________________ calendar license year as required under
AS 04.11.100(e).
Date __________________
Signature
________________________
(Licensee)
Subscribed and sworn to before me this ______ day of ___________________, ______.
______________________________
Notary Public in and for Alaska
My commission expires: _________
R/E10/99
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