Michigan Department of Labor & Economic Growth MICHIGAN LIQUOR CONTROL COMMISSION (MLCC) 7150 Harris Drive, P.O. Box 30005 Lansing, Michigan 48909-7505 PRELIMINARY INSTRUCTION FOR REQUEST TO CHANGE STATUS FROM INDIVIDUAL TO PRIVATE CORPORATION FOR MLCC USE ONLY Request ID # Business ID # [Authorized by MACR 436.1109] In order to proceed with your request please submit the items listed below. LICENSEE CHECKLIST: 1. Enclosed LC-687, Application for Transfer of Ownership, to be completed in the name of the corporation. 2. Enclosed LC-621, Stockholder Questionnaire, to be completed by EACH stockholder. 3. Enclosed LC-2099A. Change of Status, for privately held corporation where existing licensees are the sole stockholders. 4. 5. Copy of filed Articles of Incorporation. If a spouse is being added as a stockholder, we will require a fingerprint card and police report. After you have returned the application, you will receive a copy of the letter sent to the local police. When the letter is received, have your spouse go to the named police department for fingerprinting. ALL QUESTIONS MUST BE ANSWERED COMPLETELY OR NO ACTION WILL BE TAKEN BY THE COMMISSION ON YOUR APPLICATION. ANY FALSE OR FRAUDULENT STATEMENTS MADE WILL BE CONSIDERED BY THE COMMISSION AS BASIS FOR DENIAL OF THE APPLICATION, INASMUCH AS THIS WOULD BE IN VIOLATION OF SECTION 1003 OF THE STATE LIQUOR CODE. When we receive the completed forms, your request to incorporate will be presented to the Commission for consideration. If you have any questions, please contact the MLCC Licensing Division at (517) 322-1400. LC-2099 (Rev. 05/07) Authority: MAC R436.1109 Completion: Mandatory Penalty: No License The Department of Labor & Economic Growth will not discriminate against any individual or group because of race, sex, religion, age, national origin, color, marital status, disability, or political beliefs. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you may make your needs known to this agency. American LegalNet, Inc. www.FormsWorkflow.com