Laserfiche WebLink
• <br /> 5. Are you borrowing any money from any source,include family or friends,to establish and/or operate the business? <br /> YES X NO <br /> If yes,list the lender(s) <br /> 6. Will any person or entity,other than applicant,be entitled to a share of the profits of this business? <br /> YES x NO <br /> If yes,explain. (all involved persons must be disclosed on application) <br /> No silent partners <br /> 7. Will any of the furnituree,,fixtures and equipment to be used in this business be owned by others?K <br /> YES NO <br /> If yes,list such item(s)and the owner. <br /> 8. Is premises to be licensed within 150 feet of a church,school,hospital,home for the aged or indigent persons or for <br /> veterans,their wives,and children,or within 300 feet of a college or university campus? <br /> YES x NO <br /> If yes,provide name and address of such institution and where it is located in relation to the premises(Neb.Rev.Stat. <br /> 53-177X1) <br /> 9. Is anyone listed on this application a law enforcement officer? <br /> YES NO <br /> If yes,list the person,the law enforcement agency involved and the person's exact duties. <br /> 10. List the primary bank and/or financial institution(branch if applicable)to be utilized by the business. <br /> a)List the individual(s)who will be authorized to write checks and/or withdrawals on accounts at this institution. <br /> ,mss 0. *JtL �� L - <br /> Pies ,n.t� rani LneLK Rddw.' L R W'tc ?tl,t;katl L, wr¢e marX7ac*e5 w, ccR <br /> 11. List all past and present liquor licenses held in Nebraska or any other state by any person named in this application. <br /> Include license holder name,location of license and license number. Also list reason for termination of any license(s) <br /> previously held. <br /> NO kJe. — <br /> FORM 100 <br /> REV MAY 2015 <br /> PAGE 6 <br />