Officer Shareholders Disclosure Form {DLC 4030}

DLC 4030 -- OFFICER/SHAREHOLDER DISCLOSURE FORM (This form must be submitted when a corporate business is the applicant/permit holder) Ohio Revised Code 4303.293. Corporate businesses wanting to obtain a liquor permit are required to disclose ownership/controlling interest and management information to the Division. In Section B of this form, if a company owns 5% or more of the corporation, a separate Officer/Shareholder Disclosure Form is required for each company. For example, assume the liquor permit applicant is XYZ, Inc. Further assume that on XYZ, Inc’s entity disclosure form it lists ABC, LLC as having ownership in Section B. In that case, another disclosure form also needs submitted on behalf of ABC, LLC listing who/what owns ABC, LLC. www.FormsWorkflow.com