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Department of Alcoholic Beverage ntrol State of California <br /> APPLICATION FOR ALCOH,.LIC BEVERAGE LICENSE(S) <br /> ABC 211(6/99) <br /> TO:Department of Alcoholic Beverage Control File Number: 568671 <br /> 31 E CHANNEL ST Receipt Number: 2355547 <br /> ROOM 168 Geographical Code: 3905 <br /> STOCKTON,CA 95202 Copies Mailed Date: Apri120,2016 <br /> (209)948-7739 Issued Date: <br /> DISTRICT SERVING LOCATION: STOCKTON REcavEoFirst Owner: VELLURATTIL,JOSEPH C <br /> APR <br /> Name of Business: LOCAL FOOD MARKET 2 2016 <br /> Location of Business: 2650 MONTE DIABLO AVE WRONM SEIZE HETM <br /> STOCKTON,CA 95203-1100 PERMIT/ <br /> CES <br /> County: SAN JOAQUIN <br /> Is Premise inside city limits? Yes CCI1SLls Tract 0009.00 <br /> Mailing Address: <br /> (If different from <br /> premises address) <br /> Type of license(s): 20 <br /> Transferor's license/name: 457178 / GIRN,JARNAIL SINGH Dropping Partner: Yes No t� <br /> License Type Transaction Type Fee Type Master Dup Date Fee <br /> 20-Off-Sale Beer And Win- ANNUAL FEE NA Y 0 04/20/16 $254.00 <br /> 20-Off-Sale Beer And Win- PERSON-TO-PERSON TRANSFER NA Y 0 04/20/16 $50.00 <br /> Total $304.00 <br /> Have you ever been convicted of a felony? No <br /> Have you ever violated any provisions of the Alcoholic Beverage Control Act, or regulations of the <br /> Department pertaining to the Act? No <br /> Explain any"Yes"answer to the above questions on an attachment which shall be deemed part of this application. <br /> Applicant agrees(a)that any manager employed in an on-sale licensed premises will have all the qualifications <br /> of a licensee,and(b)that he will not violate or cause or permit to be violated any of the provisions of the <br /> Alcoholic Beverage Control Act. <br /> STATE OF CALIFORNIA County of SAN JOAQUIN Date: April 20, 2016 <br /> Under penalty of perjury,each person whose signature appears below,certifies and says:(1) He is an applicant,or one of the applicants,or an executive <br /> officer of the applicant corporation,named in the foregoing application,duly authorized to make this application on its behalf;(2) that he has read the <br /> foregoing and knows the contents thereof and that each of the above statements therein made are true;(3) that no person other than the applicant or <br /> applicants has any direct or indirect interest in the applicant or applicant's business to be conducted under the license(s)for which this application is made; <br /> (4) that the transfer application or proposed transfer is not made to satisfy the payment of a loan or to fulfill an agreement entered into more than ninety <br /> (90)days preceding the day on which the transfer application is filed with the Department or to gain or establish a preference to or for any creditor or <br /> transferor or to defraud or injure any creditor of transferor;(5) that the transfer application may be withdrawn by either the applicant or the licensee with <br /> no resulting liability to the Department. <br /> Effective July 1,2012,Revenue and Taxation Code Section 7057,authorizes the State Board of Equalization and the Franchise Tax Board to <br /> share taxpayer information with Department of Alcoholic Beverage Control.The Department may suspend,revoke,and refuse to issue a license <br /> if the licensee4s name appears in the 500 largest tax delinquencies list.(Business and Professions Code Section 494.5.) <br /> Applicant Name(s) Applicant Signature(s) <br /> See 211 Signature Page <br /> VELLURATTIL,JOSEPH C <br />