Laserfiche WebLink
ALCOHOLIC BEVERAGES CONTROL.COMMISSION <br /> BENEFICIAL INTEREST CONTACT- Individual (continued) <br /> Ownership I Interest <br /> If you hold a direct beneficial interest <br /> Using the definition above,do you hold a direct (j)DIrect Qind!rect in the proposed licensee,please list o0a/o <br /> or indirect interest in the proposed licensee? the%of interest you hold. <br /> If you hold an indirect beneficial interest in this license,please complete the Ownership/Interest Table below. <br /> Ownership/Interest <br /> If you hold an indirect interest in the proposed licensee, please list the organization(s)you hold a direct interest in which, in <br /> turn, hold a direct or indirect interest in the proposed licensee. These generally include parent companies, holding companies, <br /> trusts,etc. A Beneficial Interest-Organization Form will need to be completed for each entity listed below. <br /> Name of Beneficial Interest-Organization FEIN <br /> Other Beneficial Interest <br /> List any indirect or indirect beneficial or financial interest you have in any other Massachusetts Alcoholic Beverages License(s). <br /> Name of License Type of License License Number Premises Address <br /> ASIS Group;Inc,/Mashpee Mart X15 OfF Premises 00068-PK 0670 44 Falmouth Road,Mashpee,MA 02649 <br /> Familial Beneficial Interest <br /> Does any member of your immediate family have ownership interest in any other Massachusetts Alcoholic Beverages Licenses? <br /> Immediate family includes parents,siblings,spouse and spouse's parents. Please list below. <br /> Relationship to You ABCC License Number Type of Interest(choose primary function) Percentage of Interest <br /> Prior Disciplinary Action <br /> Have you ever been involved directly or indirectly in an alcoholic beverages license that was subject to disciplinary action? If <br /> yes, please complete the following: <br /> Date of Action Name of License State City Reason for suspension,revocation or cancellation <br />