Form Abc 208 A PDF Details

In the intricate landscape of regulatory compliance that governs the operations of businesses dealing in alcoholic beverages in California, the Department of Alcoholic Beverage Control stands as a vigilant overseer, ensuring that all entities adhere to the stringent standards set forth to maintain order and public safety. Among the array of forms and procedural documents, the ABC 208 A form represents a critical piece of documentation required by a diverse group of individuals closely linked to the alcoholic beverage industry within the state. This mandatory Individual Personal Affidavit is meticulously designed to collect comprehensive personal information from sole owners, their spouses, general partners, officers of corporations, major stockholders, and similar stakeholders in businesses that hold or apply for alcoholic beverage licenses. The form captures essential details ranging from personal identification, including social security and driver’s license numbers, to deeper insights into one’s background, employment history, and any potential legal infractions, painting a holistic picture of the applicant’s suitability and integrity in the context of alcoholic beverage regulations. Additionally, it delves into financial contributions made towards the business, necessitating further disclosure of economic engagements through Form ABC-208-B under certain conditions. The ABC 208 A form, thus, serves as a cornerstone in the vetting process, ensuring that individuals with significant control or financial interest in alcoholic beverage enterprises meet the rigorous ethical and legal standards set by the State of California.

QuestionAnswer
Form NameForm Abc 208 A
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesabc 208b, have abc form pdf, have abc form, you abc form pdf

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Department of Alcoholic Beverage Control

 

 

 

 

 

State of California

INDIVIDUAL PERSONAL AFFIDAVIT

 

 

 

 

Gavin Newsom, Governor

 

 

 

 

 

Instructions: This form must be completed by: sole owners and their spouses; each general partner

 

 

and their spouses; officers of a corporation and a majority of the board of directors; persons holding

 

 

10% or more of the capital or stock of a corporation and their spouses; persons holding 10% or more

 

FINGERPRINTING (ABC USE ONLY)

of the capital or stock of a limited liability company or limited partnership and their spouses.

 

Active

Livescan

If Item #23b is checked, you must complete Form ABC-208-B, Financial Affidavit.

 

Date:

 

 

 

 

 

 

 

 

1.

FIRST NAME

 

MIDDLE NAME

LAST NAME

 

2. PREVIOUS NAME(S) (Include maiden name, aka, alias)

 

 

 

 

 

 

 

 

3.

PREMISES ADDRESS

 

 

 

 

 

4. PREMISES TELEPHONE NUMBER

 

 

 

 

 

 

 

 

 

5.

HOME ADDRESS

 

 

 

 

 

 

6. HOME TELEPHONE NUMBER

 

 

 

 

 

 

7.

SOCIAL SECURITY NUMBER

8. DRIVER'S LICENSE OR ID NUMBER

9. STATE WHERE DL OR ID ISSUED

10. WORK OR CELL TELEPHONE NUMBER

 

 

 

 

 

 

 

 

 

11.

PERSONAL DATA

 

HEIGHT

WEIGHT

EYE COLOR

 

HAIR COLOR

 

 

Male

Female

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12.

BIRTHDATE

 

13. BIRTHPLACE (City, State, Country)

14. MARITAL STATUS

 

 

 

 

 

 

 

 

Single

Divorced

Widow(er)

 

 

 

 

 

Married

Separated

Registered Partner

 

 

 

 

 

 

 

15.

SPOUSE'S/REGISTERED PARTNER'S NAME (Last, first, middle) (Include alias)

16. MARRIAGE DATE

 

17. MARRIAGE PLACE (City, State)

 

 

 

 

 

 

 

 

 

 

18.

I AM OR WILL BE

 

 

 

 

 

 

 

 

Sole Owner

Spouse/Registered Partner

Partner

GeneralLimitedPartner

Limited Partner

Manager

Food Lessee

Director

Stockholder

OfficerTitle: LLC Member/Managing Member

19. Do you now have any direct, or indirect, interest in any other alcoholic beverage business, or have you ever been an alcoholic

beverage licensee or an officer or director of a corporate licensee in or outside of California?

Yes

No

IF YES, EXPLAIN (List License number and/or premises address)

20. Have you as an individual, a partner, or while an officer, director, or stockholder of a corporation ever had an alcoholic

beverage license denied, suspended, revoked, or an offer in compromise accepted or rejected?

Yes

No

IF YES, EXPLAIN

21. EMPLOYMENT HISTORY (Past five years - include unemployed, student, homemaker, etc. Use additional sheets if needed.)

FROM (MONTH/YEAR)

TO (MONTH/YEAR)

JOB TITLE

COMPANY NAME AND CITY

22.Have you ever, anywhere or at any time, (1) forfeited bail, (2) been convicted, (3) fined, or (4) placed on probation for any violation of the law? (5) Are you now actively being prosecuted for a criminal offense?

(If any of these events has occurred, this question must be answered "Yes" regardless of subsequent court action resulting in expungement, unless an order sealing records under Section 1203.45 of the Penal Code, relating to persons under age 18 years,

has been issued. If no order has been issued, the answer must be "Yes.")

Yes

No

ARREST DATE

PLACE OF ARREST

OFFENSE

RESULT/DISPOSITION

23. FINANCIAL CONTRIBUTION TO THE BUSINESS (If Box B is checked, complete Form ABC-208-B)

A.I am not making a contribution in any form

B.I am making a financial contribution

C.I am contributing labor/expertise only

D.Same as the affidavit of

I have read all of the above and declare under penalty of perjury that each and every statement is true, correct and complete.

AFFIANT SIGNATURE

TITLE

DATE SIGNED

PLACE SIGNED

ATTEST (ABC EMPLOYEE OR NOTARY PUBLIC)

ABC-208-A (rev. 01-19)

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