102-Application for Alcoholic Beverage License.pdfDepartment of Alcoholic Beverage Control State of California
APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S)
ABC 211 (6/99)
TO:Department of Alcoholic Beverage Control File Number: 506851
100 PASEO DE SAN ANTONIO Receipt Number: 2033901
ROOM 119 Geographical Code: 4303
SAN JOSE, CA 95113 Copies Mailed Date: December 22, 2010
(408) 277-1200 Issued Date:
First Owner:
Name of Business:
Location of Business:
SAN JOSE
JAWANDHA, SUKHPAL
CUPERTINO LIQUORS
7335 BOLLINGER RD
STE F
CUPERTINO, CA 95014-4328
County:
SANTA CLARA
Is Premise inside city limits? Yes
Census Tract
5078.07
Mailing Address:
(If different from
premises address)
Type of license(s):
Transferor's license/name: 333785 / GORAYA, DALJIT SINGH
Dropping Partner:
Yes No
Transaction Type Fee Type
_ yp
Master
Dup pate
Fee
—
21 - Off -Sale General
PREMISE TO PREMISE TRANSFER NA
y
0 12/22/10
$100.00
21 - Off -Sale General
PERSON -TO -PERSON TRANSFER NA
y
0 12/22/10
$1,250.00
21 - Off -Sale General
ANNUAL FEE NA
y
0 12/22/10
$582.00
NA
FEDERAL FINGERPRINTS NA
N
2 12/22/10
$48.00
NA
STATE FINGERPRINTS NA
N
2 12/22/10
$78.00
Total
$2,058.00
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 be deemed part of this
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 SANTA CLARA Date: December 22, 2010
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 officer
of the applicant corporation, named in the foregoing application, duty 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 all 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,
Applicant Name(s) Applicant Signature(s)
JAWANDRA, Stff<HPAL