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SECTION 5 — CONTRACTS OR AGREEMENTS ' <br />Business Name (D/B/A) <br />These <br />copies <br />agreement <br />disclosure <br />INTERESTED <br />sheet. <br />questions <br />of agreements <br />gives <br />of those <br />PARTIES <br />must be answered about this business for every person or entity listed as the applicant and <br />must be submitted with this application If the management, service, or other contractual <br />a person or entity control of the licensed premises or the sale of alcoholic beverages, <br />persons must be made in the section labeled "DIRECT INTEREST" in the DISCLOSURE OF <br />section They must also submit fingerprints and a related party personal information <br />/ <br />1 <br />No © <br />Is there a management contract, franchise agreement, or service agreement in <br />connection with this business? <br />Yes • <br />Please sign and date <br />Applicant's Signature Date <br />2. <br />Are there any agreements which require a payment of a percentage of gross or net <br />receipts from the business operation? <br />Yes • <br />No ri <br />3 <br />No la <br />Have you or anyone listed on this application, accepted money, equipment or <br />anything of value in connection with this business from a manufacturer or <br />wholesaler of alcoholic beverages'? <br />Yes • <br />SECTION 6 —SPECIAL LICENSE REQUIREMENTS <br />(DOES NOT.APPLY TO BEER AND WINE LICENSES) <br />Please check the appropriate "Special Alcoholic Beverage License" box of the license for which you are <br />applying Fill in the corresponding requirements for each Special License type <br />❑ Quota Alcoholic Beverage License ❑ Special Alcoholic Beverage License <br />❑ Club Alcoholic Beverage License <br />This license is issued pursuant to , Florida Statutes or Special Act, and as such we <br />acknowledge the following requirements must be met and maintained <br />Please sign and date <br />Applicant's Signature Date <br />Auth. 61A-3.020 & 61A-5.0017, FAC 4 <br />Eff. 7/30/12 <br />