APPLICATION FOR OPERATORíS LICENSE

to serve Fermented Malt Beverages and Intoxicating Liquors

 

I, the undersigned, do hereby respectfully make application to the Town of Arena, Iowa County, Wisconsin for a License to serve Fermented Malt Beverages and Intoxicating Liquors, subject to the limitations imposed by Section 125.32(2) and 125.68(2) of the Wisconsin Statutes and all acts amendatory thereof and supplementary thereto, and hereby agree to comply with all laws, resolutions, ordinances and regulations, Federal, State or Local, affecting the sale of such beverages and liquors if a license be granted to me.

 

Name of Applicant: ___________________________________†† Age:______†† DOB: _______

 

Address of Applicant:___________________________________________________________

 

Have you been convicted of any felony or of violating any law of the State of Wisconsin or of the United States? ___________________†† If so, date of such conviction:_________________

 

Have you been convicted of violating any license law or ordinance regulating the sale of fermented malt beverages or intoxicating liquors? __________ Violation:_________________

 

 

Please check one of the following:

 

_______ I have held an operatorís license in the Town of Arena within the last two years.

 

_______ I have held an operatorís license in the State of Wisconsin within the last two years

††††††††††††††††††††††† in the ______________________________________________.

 

_______ I have not held an operatorís license within the last two years, but have completed

††††††††††††††††††††††† bartenderís school.(Please attach a copy of proof of schooling.)

 

_______ I have not held an operatorís license within the last two years and will be attending

††††††††††††††††††††††† bartenderís school.(Required by WI Statutes Section 125.17(6))

 

 

The below signed applicant agrees that all statements made by the applicant are true.

 

_______________________________________

††††††† ††††††††(Applicant Signature)

 

 

Subscribed and sworn to before me this _____ day of ___________________, ___________.

 

_____________________________________, Notary Public, __________ County, Wisconsin.