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TULALIP LIQUOR COMMISSION 6406 MARINE DRIVE NW TULALIP, (The Tulalip Tribes)

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File type: PDF

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TULALIP LIQUOR COMMISSION
6406 MARINE DRIVE NW
TULALIP, WA 98271
TULALIP LIQUOR LICENSE
RENEWAL APPLICATION
BUSINESS INFORMATION:
Business Name Federal Tax Identification Number
(___) ____-____
Street Address City State Zip Telephone #
____-____-____
Proprietor Last Name First Middle Initial SS#
LIQUOR INFORMATION
Tulalip Liquor License No. Date Issued Expiration Date
WA ST Liq Control Board Lic No. Date Issued Expiration Date
Do you Sell Liquor by the Drink? YES NO
Do you Sell Beer in bottles and/or Original Packages? YES NO
Do you Sell Wine in bottles and/or Original Packages? YES NO
CHANGES
Have you had any changes in ownership or operations? YES NO
If Yes, Explain:
CRIMINAL VIOLATIONS
Has any Owner(s), Partner or Spouse been charged, arrested, pleaded guilty, forfeited bond or
been convicted of any criminal statute, including Tribal Ordinance, Federal or State Law, including
any traffic violations involving intoxicating Liquor? YES NO ; If so, state the nature of charge,
date of location and disposition of the case.
LIQUOR VIOLATIONS
Has any Owner, Partner, Spouse r Employee been cited by Washington State Liquor Control Board
or Tulalip Liquor Commission? YES NO ; If so, state the nature or charges, date,
location and disposition of the case.
TRIBAL ORDINANCES
Has the Firm or any Owner, Partner, or Director been cited by the Tulalip Tribes for a violation of
any Tulalip Ordinance? YES
NO If so, state the nature of this charge, date, and
disposition of the case.
DECLARATION
I, , Declare, under the penalties of perjury and/or the revocation
of any licenses granted pursuant hereto, that I am the duly authorized representative of the Firm or
Corporation making this application and that the answers contained in said application, including
any accompanying information, have been examined by me and that the matters and things set
forth therein are true and correct and complete.
Partner – President – Secretary Date
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TULALIP LIQUOR COMMISSION 6406 MARINE DRIVE NW TULALIP, (The Tulalip Tribes)

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Completed 20 July 2020

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