Application For Transfer Of Stock Within A Corporation Or Partnership Change
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Application For Transfer Of Stock Within A Corporation Or Partnership Change Form. This is a Connecticut form and can be use in Department Of Consumer Protection Statewide.
Tags: Application For Transfer Of Stock Within A Corporation Or Partnership Change, Connecticut Statewide, Department Of Consumer Protection
STATE OF CONNECTICUT
DEPARTMENT OF CONSUMER PROTECTION
Liquor Control Division
Telephone: (860) 713-6210
Fax: (860) 713-7235
Website: http://www.ct.gov/dcp
APPLICATION FOR TRANSFER OF STOCK WITHIN A
CORPORATION or PARTNERSHIP CHANGE
Backer Entity Name:____________________________________________________________
Phone #:____________________________ E-Mail:___________________________________
Permittee Name:_______________________________________________________________
Business Address:______________________________________________________________
Trade Name:_____________________________________Permit #:______________________
PRESENT STOCK OR PARTNERSHIP SET UP:
NAMES OF SHAREHOLDERS OR PARTNERS
AMOUNT OF STOCK OR % OF PARTNERSHIP HELD
PROPOSED STOCK OR PARTNERSHIP SET UP:
**Please indicate any new issued shares or partners
NAMES OF SHAREHOLDERS OR PARTNERS
AMOUNT OF STOCK OR % OF PARTNERSHIP HELD
DO ANY NEW SHARESHOLDERS OR PARTNERS HOLD SHARES OR PARTNERSHIP IN ANY
OTHER PERMIT PREMISES?
YES
NO
If YES, Please Provide PERMIT NUMBER: _____________________________
Then provide proposed member’s name and indicate whether he/she is a permittee or backer on the permit.
**Attach a separate sheet with this information
I do hereby affirm that the information contained in this affidavit is true to the best of my knowledge.
Signature of Backer Entity (New Shareholder or Partner):
X ________________________________________________________________ Date: __________________________
Print Name Clearly:
X_________________________________________________________________ Date: __________________________
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