Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Application For Registration Form. This is a New Hampshire form and can be use in Liquor Commission Statewide.
Loading PDF...
Tags: Application For Registration, New Hampshire Statewide, Liquor Commission
NEW HAMPSHIRE LIQUOR COMMISSION
APPLICATION FOR REGISTRATION
The Undersigned ____________________________________of the city of __________________
Name of Company
Location
in the State of ___________________hereby requests that the application of
____________________________for registration as the Liquor Wine Representative of this company
Name of Liquor wine Representative
be granted.
We certify:
a. That to the best of our knowledge the information given by the applicant is true and correct;
b. That to the best of our knowledge the applicant is honest, truthful, of good reputation and has
never been refused registration as a representative of a distiller or wine manufacturer in any
state or had such registration cancelled and that his is entirely worthy of being granted a
registration;
c. That he is entitled to enter a liquor store in the State only with specific permission of the
Commission and then only for purposes of sales promotions and to secure information on
inventory movement;
d. That the applicant has been advised:
1. that he is to conduct himself as our representative strictly in accordance with the
relevant provisions of the New Hampshire Liquor Commission and the regulations
made there under and directions issued by the Commission from time to time;
2. that he may call upon licensed premises to promote the listed product he represents.
If samples are given, they must have been purchased from a New Hampshire retail
store. Samples are restricted for this use only;
e. that we will notify the Board immediately if the applicant ceases to be employed by
our company.
______________________________
Name of Company
______________________________
Signature of Officer
______________________________
Title
__________________________SS
Date____________________
Personally appeared before me____________________________ known to be the person
Signing Officer of Company
who executed the above affidavit and made oath that the same is true.
_______________________________
Justice of Peace or Notary Public
American LegalNet, Inc.
www.FormsWorkflow.com