A corporation must furnish a photostatic copy of the filing receipt for the Certificate of Incorporation
om the New York State Secretary of State. A corporation from outside New York State must furnish a
photostatic copy of its application for authority to do business in New York State from the New York State
Secretary of State. Some applications require proof of the election of the corporate officers, and in such
cases, there must be a filed copy of the minutes of the corporation meeting, electing directors and
All Officers must be fingerprinted and also any stockholder of ten (10) percent or more of the stock.
Individuals operating under a trade name must present a certified copy of the trade name certificate in
the County Clerk’s Office.
A partnership conducting business whether or not under a trade name, must submit a certified copy of
partnership certificate filed in The County Clerk’s Office.
Surety Bond in the Amount of Ten thousand Dollars ($10,000). Made payable to the Town of Hempstead.
If the applicant is a corporation, state its principal place of business and the name and address of a
person residing within the Town of Hempstead on whom papers may be served:
The applicant hereby states that no person has provided any funds for the organization or operation of
this business except as stated in this application and if any such funds are hereafter obtained the Town of
Hempstead is to be notified immediately: and in the event of a change of officers, directors or stockhold-
ers, the Town of Hempstead be informed forthwith of license may be revoked.
Being duly sworn deposes and says: that he is the applicant above named, that he has read the foregoing
application for a license, and knows the contents thereof and that the same is true and his own knowl-
edge, except as to the matters therein stated to be alleged upon information and belief and that as to
those matters he believes to be true.
THIS AFFIDAVIT MUST BE COMPLETED
STATE OF NEW YORK
COUNTY OF NASSAU
Sworn to before me this
Day of 20
Signature of Applicant