CITY OF CARROLLTON 

 

APPLICATION FOR LICENSE TO SELL ALCOHOLIC LIQUOR 

 

ORIGINAL 

RENEWAL 

To the Mayor of the City of Carrollton, Illinois: 

 

The undersigned hereby makes application for a license to sell alcoholic liquor under a Class license, 
of the classification of licenses as provided in the ordinances of Carrollton, Illinois, regulating the sale of Alcoholic 
liquor, and the laws of the State of Illinois, now in force, or which may be hereafter passed, from the 
day of to . 

 

1. Name of your Business 

2. Location where you propose to engage in business 

3. Is the proposed location of your business within 100 feet of any church, school, hospital, home for the aged 
or indigent persons, or for veterans, their wives or children or any military or naval station? 


4. Names of all persons owning any interest in this business 

 

APPLICANT(S) 

 

5. Name Name 

 (A) Age (A) Age 

 (B) Citizenship (B) Citizenship 

 If you are a naturalized citizen If you are a naturalized citizen 

 Insert date Insert date 

 and place and place 

 (C) Are you a resident of Carrollton? (C) Are you a resident of Carrollton? 

 

 (D) Place of birth (D) Place of birth 

 (E) Have you ever been convicted of (E) Have you ever been convicted of 

 pandering or other crime or mis- pandering or other crime or misdemeanor 

 demeanor opposed to decency or opposed to decency or morality? 

 morality? 

 (F) Have you ever been convicted of (F) Have you ever been convicted of a 

 a felony? felony? 

 (G) Have you ever been convicted of (G) Have you ever been convicted of being 

 being the keeper of a house of the keeper of a house of ill-fame? 

 ill-fame? 

 (H) Are you now keeping a house of (H) Are you now keeping a house of ill- 

 ill-fame? fame? 

 (I) Have you made application for (I) Have you made application for another 

 another liquor license? Liquor license? 

 If so, where? If so, where? 

 (J) If a license is granted to you, do (J) If a license is granted to you, do you 

 you promise not to violate any of promise not to violate any of the laws 

 the laws of the State of Illinois or of the State of Illinois or of United 

 of United States or of the City of States or the City of Carrollton, Illinois, 

 Carrollton, Illinois, in the conduct in the conduct of your place of 

 of your place of business? business? 

 

STATE OF ILLINOIS ) 

 ) ss. 

COUNTY OF GREENE ) 

 

 , being duly sworn on oath deposes and says that the 
listed are the applicant(s) in the foregoing application; and that the answers of the interrogatories are true and correct. 

 

 

 

 

Subscribed and sworn to before me this day of A.D. 20 

 

 

 

 NOTARY PUBLIC