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Non Judicial Foreclosure Affidavit Form. This is a Arizona form and can be use in Liquor Licenses And Control Statewide.
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Tags: Non Judicial Foreclosure Affidavit, LIC1011, Arizona Statewide, Liquor Licenses And Control
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ARIZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL
800 W Washington 5th Floor
Phoenix AZ 85007-2934
www.azliquor.gov
(602) 542-5141
NON-JUDICIAL FORECLOSURE AFFIDAVIT
STATE OF ARIZONA
COUNTY OF MARICOPA
)
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ss.
I, _____________________________________, having been duly sworn do hereby state that I am:
1.
a secured party and have a perfected security interest in liquor license #_________________,
the attorney for the secured party _______________________________________________.
(name of secured party you represent)
2. The financing statement with liquor license #_________________________ as collateral was
filed with the Secretary of State (SOS) on _______________ (copy attached).
(date filed with SOS)
3. Debtor, party _______________________________________________. Is in default under the
(name of debtor)
security agreement.
4. A notice of proposed disposition of collateral was sent to the debtor on _______________.
(date sent to debtor)
5. A
public
private sale was held on _______________ located at:
(date sale was held)
_______________________________________________________ and the sale was conducted in a
(street address, city, state, zip)
commercially reasonable manner with notice of the sale having been published on _____________
(date sent to debtor)
in _____________________________________________(copy of sale notice attached).
(name of publication)
Lic 1011 9/2009
Individuals requiring special accommodations please call 602) 542-9027
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6.
Liquor license #___________________ was sold to __________________________________
of _______________________________________________________ (copy of bill of sale attached).
(street address, city, state, zip)
Liquor license #__________________ was retained in satisfaction of the obligation and notice
was given to the debtor on ___________________ (copy of notice attached).
(date of notification)
7. Affiant further states that all things required to be done under A.R.S. §47-9010 et. Seq. (Uniform
Commercial Code – Secured Transactions), have been done to entitle the affiant to lawfully
dispose of or otherwise act with respect to liquor license #___________________.
Affiant further states he/she is aware that the Department of Liquor Licenses and Control is
making no determination of the secured party’s property interest in liquor license
#________________ but is relying on affiant’s documentation and this affidavit solely for the
purpose of allowing the affiant to take action with the department as to liquor license
#_________________. Affiant agrees to hold the Department of Liquor Licenses and Control
harmless from any liability incurred by the department in reliance on the affiant’s representations
and documentation.
Wherefore, Affiant further saith not.
______________________________________________, declare that I have read this Affidavit and
(print name)
the contents and all statements are true, correct and complete.
_______________________________________________
(signature of AFFIANT)
The foregoing instrument was acknowledged before me this
________ day of ____________________, _____________
(month)
(year)
______ ____________________________________
(signature of NOTARY PUBLIC)
My commission expires on: _____________________
State of _____________County of ________________
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