Application for a retail tobacco product license shall be made to the County Executive in writing,
under oath, signed by the applicant, if an individual, or by the duly authorized agent thereof if a legally constituted organization, and shall include the following information and statements:
(A) The name, age, date of birth, last three residence addresses and Social Security number of the applicant. In the case of a partnership, the application must contain the names, ages, and last three residence addresses and Social Security number of each partner;
(B) If a corporate license is sought, the application must contain the name of the corporation, the date of incorporation, the articles of incorporation and the names, addresses and Social Security numbers of all officers and directors. If a majority of the stock of the corporation is owned by one person, the name, address and Social Security number of that majority stockholder shall be set forth in the application;
(C) In the case of an individual, the application must contain his or her place of birth, and if the applicant is a naturalized citizen, then the date and place of naturalization must be shown;
(D) The capital investment which the applicant intends to make in the business of selling tobacco products at retail upon receipt of a license;
(E) The location, address and legal description of the premises to be licensed. If the premises are leased, the applicant shall attach a copy of the lease to the license application;
(F) A statement whether the applicant has made any other application for a tobacco retail license and what disposition, if any, was made of the application and a statement that the applicant will not violate any of the laws of the state or the United States, and that the applicant will not violate any of the ordinances of the county;
(G) A statement whether or not the applicant was ever convicted of a felony or misdemeanor, and if the applicant has a conviction, a statement of the nature of the crime, the date and place of conviction and the sentence imposed; and
(H) Each license holder must tender to the County Executive his or her driver’s license or state identification card to be copied and held on file with his or her license application along with his or her Social Security number.
(1980 Code, § 120.11) (Ord. 09-181, adopted 6-18-2009)