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Pazt 1 - General Information (Off Sale Intoxicating) <br />14. (b)Of the above cost of assets acquired, state the amount that is <br />provided by the person(sA investing in this business. <br />j� <br />(Attach supporting proo of the source of such money. <br />15. Give full names, addresses, telephone numbers of all persons, other <br />than the applicant, who have any financial interest in the business, <br />buildi,gs, premises, fixtures, furniture, or stock in trade. State <br />the nature of the interest, amount thereof, and the terms for payment <br />or other reimbursement. (This shall include, but not be limited to <br />any lessees, lessors, mortgagors, lendors, lien holders, trustees, <br />trustors, and persons who have cosigned -otes or otherwise loaned, <br />pledged, or extended security for an indebtedness of the applicant.) <br />__..� �1►\1� jpy�A�"A Phone <br />I. L��Ly�` <br />Full Name! <br />Address <br />Nat4ia of Interest, etc. <br />Fall Name Phone _ <br />Address — <br />Nature of Interest, etc. <br />Full Name Phone <br />Address <br />Nature of Interest, etc. <br />Full Nal^e <br />Address <br />Nature cf Interest, etc. <br />Phone <br />