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AA Department of Alcoholic Beverage Control State of California APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) ABC 21 l 6199 ..F� TO:Department of Alcoholic Beverage Control File Number: 579365 31 E CHANNEL ST Receipt Number: 2415568 T ROOM 168 Geographical Code: 3905 STOCKTON, CA 95202 Copies Mailed Date: March 9,2017 (209)948-7739 Issued Date: REcEIVE[) DISTRICT SERVING LOCATION: STOCKTON First Owner: sAMRA,BOOTA S MAR 3 20x7 Name of Business: �j/►'!'o t /77,q r 4e ENWI O*EiVTAL y Location of Business: 201 W POPLAR ST PERA�lITI�RViOEkTH STOCKTON,CA 95203 County: SAN JOAQUIN Js-ftemise.inside city_limits? Yes - _ Census Tract 0004.02 Mailing Address: (If different from premises address) Type of license(s): 20 Transferor's license/name: 547333 1 PAY AND PICK LLC Dropping Partner: Yes_ No License Type transaction Tune Fee Type Master � Date Fee 20-Off-Sale Beer And Win ANNUAL FEE NA Y 0 03/09/17 $254.00 20-Off-Sale Beer And Win, PERSON-TO-PERSON TRANSFER NA Y 0 03/09/17 $50.00 Total $304.00 Have you ever been convicted of a felony? No Have you ever violated any provisions of the Alcoholic Beverage Control Act, or regulations of the Department pertaining to the Act? No Explain any"Yes"answer to the above questions on an attachment which shall he deemed part ofthis application. Applicant agrees(a)that any manager employed in an on-sale licensed premises will have all the qualifications of a licensee, and(b)that he will not violate or cause or permit to be violated any of the provisions of the Alcoholic Beverage Control Act. STATE OF CALIFORNIA County of SAN JOAQUIN Date: March 9, 2017 Under penalty or perjury,each person whose signature appears below,certifies and says:(1) He is an applicant,or one of the applicants,or an executive 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 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 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', (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 (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 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 no resulting liability to the Department. Effective July 1,2012,Revenue and Taxation Code Section 7057,authorizes the State Board of Equalization and the Franchise Tax Board to share taxpayer information with Department or Alcoholic Beverage Control.The Department may suspend,revoke,and refuse to issue a license if the licenseeys name appears in the 500 largest tax delinquencies list.(Business and Professions Code Section 494.5.) Applicant Name(s) Applicant Signature(s) See 211 Signature Page SAMRA,BOOTA S (�D O / c£° ! ~✓-fQ3