Section 110. Information to be requested in applications for licenses or permits

1. The following  shall  be  the  information  required  on  an
  application for a license or permit:
    (a) A statement of identity as follows:
    (i)  If  the  applicant  is an individual, his name, date and place of
  birth, citizenship, permanent home address, telephone number and  social
  security  number, as well as any other names by which he has conducted a
  business at any time.
    (ii) If the applicant is a corporation,  the  corporate  name  of  the
  applicant, its place of incorporation, its main business address (and if
  such  main  business address is not within the state, the address of its
  main place of business within the state), other names by  which  it  has
  been  known or has conducted business at any time, its telephone number,
  its  federal  employer  identification  number,  and  the  names,  ages,
  citizenship, and permanent home addresses of its directors, officers and
  its  shareholders  (except  that  if there be more than ten shareholders
  then those shareholders holding ten percent or more of any class of  its
  shares).
    (iii)  If  the applicant is a partnership, its name, its main business
  address (and if such main business address is not within the state,  the
  address  of its main place of business within the state), other names by
  which it has been known or has  conducted  business  at  any  time,  its
  telephone  number,  its  federal employer identification number, and the
  names, ages, citizenship, and permanent home addresses of  each  of  its
  partners.
    (b)  A  statement identifying the street and number of the premises to
  be licensed, if the premises have a street  and  number,  and  otherwise
  such  description  as  will  reasonably  indicate  the locality thereof;
  photographs, drawings or other items related to the  appearance  of  the
  interior or exterior of such premises, and a floor plan of the interior,
  shall  be  required.  The  applicant  shall also state the nature of his
  interest in the premises; and the name of any other person interested as
  a partner, joint venturer, investor or lender with the applicant  either
  in the premises or in the business to be licensed.
    (c)  A  description  of  any  other alcohol beverage license or permit
  under this chapter or any other alcoholic beverage  control  law  which,
  within  the  past  ten  years,  the  applicant  (including any officers,
  directors, shareholders or partners listed in the statement of  identity
  under  paragraph  (a)  of  this  subdivision  or  the spouse of any such
  person) or the applicant's spouse held or applied for.
    (d) A statement that such applicant or the applicant's spouse has  not
  been  convicted  of  a  crime addressed by the provisions of section one
  hundred twenty-six of this article  which  would  forbid  the  applicant
  (including  any  officers, directors, shareholders or partners listed in
  the statement of identity under paragraph (a) of this subdivision or the
  spouse of such person) or the applicant's spouse to traffic in alcoholic
  beverages, a statement whether  or  not  the  applicant  (including  any
  officers, directors, shareholders or partners listed in the statement of
  identity  under  paragraph  (a) of this subdivision or the spouse of any
  such person) or the applicant's  spouse  is  an  official  described  in
  section  one  hundred twenty-eight of this article, and a description of
  any  crime  that  the  applicant  (including  any  officers,  directors,
  shareholders  or partners listed under paragraph (a) of this subdivision
  or the spouse of any such person) or the  applicant's  spouse  has  been
  convicted  of and whether such person has received a pardon, certificate
  of good conduct or certificate of relief  from  disabilities;  provided,
  however,  that  no  person  shall  be  denied  any license solely on the

  grounds  that  such  person  is  the  spouse  of  a   person   otherwise
  disqualified from holding a license under this chapter.
    (e)  A  statement  that  the location and layout of the premises to be
  licensed does not violate any requirement of this  chapter  relating  to
  location and layout of licensed premises, with a copy of the certificate
  of occupancy for the premises.
    (f)  A  statement that the applicant has control of the premises to be
  licensed by ownership of a fee interest or a leasehold with  a  term  at
  least as long as the license for which the application is being made, or
  by  a  binding  contract to acquire the same and a statement of identity
  under paragraph (a) of this subdivision for the lessor of any  leasehold
  with  a  copy of the lease, contract or deed evidencing fee ownership of
  the premises.
    (g) A financial statement adequate to show all persons  who,  directly
  or  indirectly  have  an  economic  interest  in  the  establishment  or
  acquisition of the business for which the license or permit  application
  is  being  made,  to identify the sources of funds to be applied in such
  establishment or acquisition, and to describe the terms  and  conditions
  governing  such establishment with copies of such financial documents as
  the authority may reasonably require.
    (h) The fingerprints of the applicants. Fingerprints submitted by  the
  applicants  shall  be  transmitted  to  the division of criminal justice
  services and may be submitted to the federal bureau of investigation for
  state and national criminal history record checks.
    2. All license or permit applications shall be signed by the applicant
  (if an individual), by an officer (if a corporation), or by all partners
  (if a partnership). Each person signing such application shall verify it
  or affirm it as true under the penalties of perjury.
    3. All license or permit applications shall be accompanied by a check,
  draft or other  forms  of  payment  as  the  authority  may  require  or
  authorize  in  the  amount  required by this chapter for such license or
  permit.
    4. If there be any change, after the filing of the application or  the
  granting  of  a license, in any of the facts required to be set forth in
  such application, a supplemental statement giving notice of such change,
  cost and source of money involved in the change, duly verified, shall be
  filed with the authority within ten days after such change.  Failure  to
  do  so  shall, if willful and deliberate, be cause for revocation of the
  license.
    5. In giving any notice, or  taking  any  action  in  reference  to  a
  licensee  of  a  licensed  premises,  the  authority  may  rely upon the
  information furnished  in  such  application  and  in  any  supplemental
  statement  connected  therewith, and such information may be presumed to
  be correct, and shall be binding upon a licensee or licensed premises as
  if  correct.    All  information  required  to  be  furnished  in   such
  application  or  supplemental statements shall be deemed material in any
  prosecution for perjury, any proceeding to revoke, cancel or suspend any
  license, and in the authority's determination to  approve  or  deny  the
  license.
    6.  The  authority  may  in its discretion waive the submission of any
  category of information described in this section for  any  category  of
  license  or permit, provided that it shall not be permitted to waive the
  requirement for submission of any such category  of  information  solely
  for an individual applicant or applicants.
    7.  The  authority  may,  by  rule,  adopt  additional  categories  of
  information  which  may  be  reasonably  necessary  to  carry  out   the
  provisions of this section.