Department of Alcoholic Beverage Control State of California PROTEST AGAINST ALCOHOLIC BEVERAGE LICENSE APPLICATION · Refer to Form ABC-510, Information Regarding ABC License Application and Protests (Rev. April 2010), before completing and submitting your protest. The ABC-510 is located at www.abc.ca.gov and in each district office. · Please print legibly or type. Incomplete and/or illegible information will cause the protest to be rejected. · You will be notified by letter whether or not your your protest is accepted. · If the Department recommends licensure, you will be afforded the opportunity to request a hearing on your protest. · If a hearing is scheduled as to whether or not a license should be granted, you or your authorized representative will need to attend the hearing to testify and/or present evidence to support your protest, or your protest will be deemed abandoned. · All protests submitted to the ABC are public records and are open to inspection pursuant to the California Public Records Act (CPRA). (Gov. Code sec. 6254 et seq. ) · A copy of all valid and verified protests (ABC-510-A) and Protestant's/Complainant's Declaration (ABC-128) will be provided to the applicant as part of the licensing process. I hereby protest the issuance of a license under the Alcoholic Beverage Control Act to: (Name(s) of Applicant(s)) For premises at: (Exact address of proposed premises) on the grounds that: Check here if additional sheets attached I, PRINT (Name of Protestant) , declare under penalty of perjury: (1) That I am the Protestant herein; (2) That I have read the above protest and know the contents thereof; and (3) That the same is true of my own knowledge except as to those matters which are therein stated on information and belief, and as to those matters I believe to be true. PROTESTANT'S SIGNATURE TELEPHONE NUMBER (Optional & non-public) SIGNED AT (City and State) DATE SIGNED PROTESTANT'S ADDRESS (Full address - Street name & number, Unit or Apt. No., City, State, & Zip Code) ABC-510-A (Rev. April 2010) American LegalNet, Inc. www.FormsWorkFlow.com