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Home My WebLink AboutBarbara WilsonCERTIFICATE OF APPOINTMENT, SWORN STATEMENT Y APPOINTEE TO LOCAL ALCOHOLIC BEVERAGE BOARD Sbte Fwm ZI65e(R3/tU5) PLEASE PRINTOR TYPE ALLINPORMA.AONREOUESTEO. RETURNALL FORMS TO: INDIANAALCONOLRND708A000 COMMISSfON - 30TWWASHINOTON STRME114 To allwho shallsee these presents,greetings:- ......__._ 1. Tory ror 1937;. and ~/county, 1935 and THEREFORE KNOW YE, that a[ a regular session and in the name and by the authority of the Slate of Intliana, we do hereby appoint and commission - Barbara Wilson of Clark (Name o/ eppantee) COpnry as a member of the Local Alcoholic Beverage Board of said county, to serve for the term of one (t) year from However, said appointee will continue [o serve until successor is appointed and qualified. 1/1/08 - 12/31/08 IN TESTIfy10NY WHEREOF, we hereby set our hands and cause to affixetl Me (SEAL) - Seal of§aid County, Done at-Jeff ~ 11 in the Year df our Lord March 42008' r of the Sfata of Indiana, to the ties! of my N-ibgd-BfIC SNgffi (O IIBfOrB rnB UIIS Wits Clark' CIRCUIT COURT CLERK OF THE Clar - County ._ _,. ~.. (CBnfinuetl on Ne ravelse sire) Barbara Wilson 1p'e'^n (moem. clay yeep soda) seatlrynembw~ asap- fnw~naraae waac ary.:ram. nrconel 1/28/33 306-30-7452 d35 W. Larkspur Dz„ Jef tersonvil le, IN 47130 Couhry ofresitlance n'ry wbge appointed Coun wM1ere Clark Jeffersonville ry aPaomlae ~N4 Aappolnm,gaavwnry(maynr,cone Clark rycounraoreoeroorco,ea,r%siw,e„/ Mayor of J ffersonville 3 miles 1 °,~g I~ Yes ~kMo rm any brwl~swpich manuhcWk¢s sglls Ir$ 9ppdg Msto •. . bPmperty wlir3malwhdf or alCdholic lfepe}"eg"P„a,aramanufaclu tl,:`s''oltl o`r ~ Y~ ~~No M~ ~;YeP`l~!,0'aoh"d>(+2'F)Y,>'ars!pTagb aroNeR .. '1 Yhs ~' No 5. Do you hold other lucrative public office or full or part-lima public employment! - 6. Have you ever been conWCtetl of a (elan ~ Yes ^ No y under Ilse laws o/ Ne Srate of Indiana or of the Unitetl States of America? (/f Yes, give rompeR orcircumsrances, charges, dates, etc. be/ow) ^ Yes ®No ^ No \TE OFINDIANA Y UNiY OF- Clark }38: - f ~ scribed antl swam to before me this '#'L (((((( y~~~~y~~ ~'~ \ ~ 0 day of ,2D©~ ~% 6slon am~lra~'°~' tlete County Mresidenca T ~~{ / M(/I Clark roee orpnm=a ,,,,,,, °r^`+la~c°uuc-. ~ .. sl ;w,ea YY~I ^r:,C,Cfi!/i,~,gryp fi^Jlrot.. A , The Indiana Afgoh~c Beverage Edmmisslon is raquestlng disclosure of yavi SorJal Security _ number in accordance with IC 4-1-9.