Owner Of Property {L-OP}

Page 1 of 1 Form L-OP (/201) OWNER OF PROPERTY L-OP (/201) 1. Trade Name of Location 2. Indicate if owner of property is: Owner of Land and Building Owner of Land Owner of Building Owner of Boat Note: If land and building are owned by different entities, complete Form L-OP for each entity. 3. Wholesaler222s (W, X) and Manufacturer222s (G, B, D) 226 Is the owner of premise information used for a storage permit (L, K) or Manufacturer222s Warehouse License (MW)? Yes No 4. Owner of Property (Individual or Business Entity) 5. Fed eral Employer Identification Number (FEIN) for Owner of Property COMPLETE THE FOLLOWING: SSN Issuing State/DL No. Date of Birth (mm/dd/yyyy) - - / / Full Legal Name of Individual, Partner, Officer (Last, First, Middle) Title/Owner SSN Issuing State/DL No. Date of Birth (mm/dd/yyyy) - - / / Full Legal Name of Individual, Partner, Officer (Last, First, Middle) Title/Owner SSN Issuing State/DL No. Date of Birth (mm/dd/yyyy) - - / / Full Legal Name of Individual, Partner, Officer (Last, First, Middle) Title/Owner SSN Issuing State/DL No. Date of Birth (mm/dd/yyyy) - - / / Full Legal Name of Individual, Partner, Officer (Last, First, Middle) Title/Owner SSN Issuing State/DL No. Date of Birth (mm/dd/yyyy) - - / / Full Legal Name of Individual, Partner, Officer (Last, First, Middle) Title/Owner IF YOU NEED MORE SPA CE USE ADDITIONAL CO PIES OF THIS PAGE American LegalNet, Inc. www.FormsWorkFlow.com