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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)