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Franchise Affidavit Form. This is a Washington form and can be use in Liquor Control Board Statewide.
Tags: Franchise Affidavit, LIQ 820-50, Washington Statewide, Liquor Control Board
Licensing and Regulation Division
PO Box 43098
Olympia WA 98504-3098
Phone: (360) 664-1600
FAX: (360) 753-2710
This affidavit is in lieu of providing a copy of the franchise agreement to the Washington State
Liquor Control Board for the below premises:
Liquor license No.
Address of real/personal property:
Name of franchiser:
Name of franchisee:
Date franchise begins:
Date franchise expires:
No. of times franchise can be renewed:
Term of each renewal:
Can franchise be assigned?
With or without franchiser’s written consent?
Signature of franchiser
I declare under penalty of perjury that all information provided on this form is true and complete
to the best of my knowledge. I understand that untruthful, misleading, or incomplete answers
whether through misrepresentation, concealment, inadvertence, or mistake are cause for denial
of a license or revocation of any liquor licenses currently held.
Signature of Applicant
Subscribed and sworn to before me, this ________ day of __________________, 2______.
Notary Public in and for the State of ________________,
residing in ___________________.
My commission expires _________________________.
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