APPLICATION FOR
A LICENSE FOR A GOING OUT OF BUSINESS SALE
INCLUDING A CLOSING OUT SALE OF GOODS, WARES
AND MERCHANDISE
DAMAGED BY FIRE, SMOKE, WATER OR OTHERWISE
ORIGINAL _________ 1ST RENEWAL ___________ 2ND RENEWAL ___________
Each is issued for 30 days only. Fee for each 30-day
period is $50.00, which is non-refundable. No extensions are permitted after the second renewal. Any application for a renewal
license cannot be made more than 13 days prior to the expiration of the previous license.
NAME OF BUSINESS ___________________________________________________
ADDRESS ______________________________________________________________
INDIVIDUAL __ PARTNERSHIP __ CORPORATION __ FIRM
__ ASSOCIATION __
LENGTH
OF TIME APPLICANT HAS BEEN IN BUSINESS AT THIS LOCATION:
_______________________________________________________________________
APPLICANT NAME ____________________________ TITLE ___________________
OWNER OF GOODS TO BE SOLD: _________________________________________
SALE WILL BE CONDUCTED IN THE FOLLOWING MANNER:
_______________________________________________________________________
SALE WILL BE CONDUCTED AT: __________________________________________
SALE WILL START ___________ 20____ AND CONTINUE TO ____________
20____
NAME OF PERSON WHO WILL BE IN CHARGE AND
RESPONSIBLE FOR THE CONDUCT OF THE SALE: _______________________________________________________________________
REASON FOR SALE: _____________________________________________________
INVENTORY OF GOODS TO BE SOLD ATTACHED TO THIS APPLICATION,
INCLUDING:
1. Itemized list of goods
to be sold, described with make and brand name, if any. The itemization should provide for clear identification.
2. Separate list of goods,
purchased 60 days or less immediately prior to the date of this
application.
3. Cost price of each item, name and address of the source,
date of purchase and delivery date and the total value of inventory at cost.
NOTE: A copy of the inventory submitted with this application
must be posted on the premises where the sale is to be conducted. This inventory need not show the cost prices.
BY VIRTUE OF THIS APPLICATION, THE APPLICANT
HEREBY WARRANTS
AND REPRESENTS THAT NO GOODS WILL BE ADDED TO THE ABOVE
DESCRIBED INVENTORY AFTER THE APPLICATION IS MADE OR
DURING
THE
SALE AND THAT THE ABOVE DESCRIBED INVENTORY CONTAINS NO
GOODS RECEIVED ON CONSIGNMENT.
"I understand that a false statement on this application
may result in either a denial of this application or subsequent revocation if the license is granted."
________________________________
____________________________
(Applicant’s Signature)
(Date)
Subscribed and sworn to before me
this day ________ of _________________,20________.
______________________________
____________________________
(Notary Public, Barry County, Michigan)
(Date Commission Expires)
Date license granted _______________________
License fee $50 paid _______________________
Date license refused _______________________
Date
license voided _______________________
Reason for voided
license __________________________________________________
GOB.APP (REV. 4/08)