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Get and Sign INDIVIDUAL PERSONAL AFFIDAVIT Alcoholic Beverage Form

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Reported to the Department as required by Rule 68. 5 CCR and a fee may be required pursuant to Sections 24071. 1 24072 B P. SIGNATURE FOR THE CORPORATION ABC-243 rev. 07/19 DATE SIGNED LIST ALL STOCK CERTIFICATES Continued from other side. LIST ALL STOCK CERTIFICATES PERCENTAGE OF CERTIFICATE NUMBER OUTSTANDING DATE OF SHARES SHARES OF STOCK ISSUED CANCELED TO WHOM ISSUED Continued on reverse I hereby certify the above are the present officers directors and/or stockholders and that each such...
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