Sample Renewal Application
03/09/2011 10:59
8458550179
TOWN OF PAWLING
PAGE 11/12
Application for Rellewftl of J.. icen~"'~
to conduct a sale pursuant to General Bush less L~w, Af UcTe 29-F
To: Town Clerk
Town of
Pursuant to Section 590 of the New York General Bus;ness L~w, npplicnlioll is llOreby 'llnde for renewal
of license No. for a period nol OXCGcclillq 30 c()II:.r;C:llliv~ enl"I"I:11 fl(\y~ br;qillllillq . _..._. .,~ ....
199 _, and terminating I 199~.
With respect to this Application for Renewal:
(1) the same is made not more than 10 days prior to date of the c.l':piraliofl oll..1CQIlSB No. ...__,_..:
(2) the goods, wares and merchandise listed in tile Inventory filed willl tile oligillal Application have not
been disposed of; attached is an Inventory or the gooc.fs, wmos find II1Ctcltmldis~ remflininq on hand;
(3) no new goods, wares and merchandise have been or will be added to Illvcn!OlY riled wilh the original
Application.
Dated:
Applicant's Name:
Signed By:
Tille:
State of New York, County of u.... SS: (Nmllr:').
being duly sworn, deposes and says: (check one of the followiny)
_ Individual Verification
deponent is .._._..._ ...._..... _~__.__._._n_
the Applicant named in the above Application; deponent has read Hm fOJrqainH Applicalionand knows
the contents tllereof; the same is true to deponent's OWIl k'lowlccl~l'~1 Elxr:r., 1[ 8'; 10 Ih8 IIwllms therein
stated to be alleged on information and belief, and as 10 Ih()~r. ,":\ltrrs tlr:P/Jll(.~lIll)cliavcs ilta be !rue,
_ Corporate Verification
deponent is the of ___'OJ'~_~___...._._.____.._
a corporation, tile ^pplic~nt flamed In U'le above Application;
depohent has read the foregoing Application andlmows II Ie COlll~'llS t1lf.'rrof; and the s::\Jl1e is true'to
del?onent's own knowledge, except as 10 the 1l1::l11crs II1~rQil1 ~Iar~d It') b~ p'l~q('cJ "pOll il1fornmlion 8nd
belief, and as to those matters deponent believes it to bg huo. -, his vcrifico:ltioll is made by deponent be-
cause Applicant Is a corporation and deponent is an oHicer 1I1ereof.
Signed: _
(Also print name under this line)
Sworn to before me on
.' 19 ....__~
. . .._..._____.. __.,_...~ Notary Public