Department of Alcoholic Beverage Control State of California DECLARATION OF SERVICE BY MAIL (Section 23985.5) Complete this form, attach the original Form ABC-207-E and return to ABC office listed below. Refer to Instructions, Form ABC-528, for more information. ABC District Office: Applicant(s) Name(s): Premises Address: DECLARATION: I, (name) by mail upon each resident of real property , do hereby declare that on (date of mailing) owner of real property within a 500-foot radius of the above-designated , I served premises, by depositing in the United States Mail, with postage fully prepaid, a sealed envelope containing a true copy of the Notice of Intention to Engage in the Sale of Alcoholic Beverages (Form ABC-207-E), a copy of which is attached hereto, giving the name(s) of the applicant(s), the type(s) of license(s) applied for, the address of the premises where the business is to be conducted, addressed to the resident/occupant for each of the following addresses (If more space is needed, use reverse or attach a separate sheet.): ADDRESS CITY ZIP CODE Continued on reverse or on attachment I declare under the penalty of perjury that the foregoing is true and correct. Executed at , California, this , day of . (Signature) ABC-207-F (1/02) American LegalNet, Inc. www.FormsWorkflow.com