any traffic violations involving intoxicating Liquor? YES NO ; If so, state the nature of charge,
date of location and disposition of the case.
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.
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.
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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