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WAC 260-13-510

Application for Class A, B, or C license—Affidavit of the applicant.

An application for a Class A, B, or C license must include an affidavit of the applicant or the applicant's agent setting forth the following:
(1) The class of license being applied for;
(2) If the applicant is an individual, his/her legal name and the legal name of his/her spouse and dates of birth, telephone number(s) and address(es);
(3) If applicable, the name, address, and telephone number of the person representing the applicant and that the person is authorized to make application on the applicant's behalf. Documented proof of authority must be attached to the affidavit;
(4) If the applicant is a corporation:
(a) The name of the corporation;
(b) The date and place of incorporation;
(c) The names, dates of birth and addresses of directors and officers who are natural persons;
(d) The names and addresses of its shareholders:
(i) If a shareholder is a corporation, then the name and place of its incorporation, and the names and addresses and dates of birth of those corporations' directors and officers;
(ii) If the applicant is a corporation ultimately owned by a not-for-profit entity without any shareholders, or is a publicly traded corporation, the information required in this subsection will be required from the directors of the not-for-profit entity, or the directors and officers of the publicly traded corporation, in lieu of the shareholders;
(iii) If the applicant is a general or limited partnership, the names, dates of birth, and addresses of the partners; if a partner is a corporation, the date of incorporation, the place of incorporation and the names and addresses and dates of birth of its directors and officers must be provided;
(5) A statement that the applicant for license accepts that at all times, the burden of proving the applicant's qualification for license rests with the applicant;
(6) A statement that the applicant consents to inquiries by the state of Washington, the commission, its employees, staff and agents into the financial, character, and other qualifications of the applicant by contacting individuals and organizations;
(7) A statement that the applicant, its owners, partners, members, directors, officers, and personnel accept any risk of adverse public notice, or circumstances, including financial loss, which may result from actions by the state of Washington, the commission, its employees, staff and agents and expressly waive any claim which otherwise could be made against the state of Washington, the commission, its employees, staff and agents;
(8) A statement that the information contained in the application is true and complete and that any false, incomplete, misleading information may be grounds for denial of the application or fine, suspension or revocation of existing license; and
(9) A statement that the applicant will comply with chapter 67.16 RCW and Title 260 WAC.
[Statutory Authority: RCW 67.16.020 and 67.16.040. WSR 08-17-050, § 260-13-510, filed 8/14/08, effective 9/14/08.]
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