Plcb 1842-2026

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The document is an Individual Financial Disclosure Affidavit required by the Pennsylvania Liquor Control Board for applicants or licensees involved in transactions such as transfers, stock purchases, or new licenses. It outlines the necessary information regarding the applicant's identity, transaction type, total consideration involved, and details about investors and sources of funds. The affidavit must be signed under penalty of perjury, ensuring that all financial disclosures are accurate.

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Click ‘Get Form’ to open the PLCB-1842 in the editor.
Begin by entering the name of the applicant/licensee, along with the license identification number and license number issued by the Pennsylvania Liquor Control Board. Don’t forget to include the address of the premises.
Indicate the type of transaction by placing a check mark in the appropriate box. This could be a transfer, stock purchase, or new application.
In Section 3, list all dollar amounts involved in this transaction from Sections 3A through 3J. Ensure you add each line to determine the total consideration involved.
For each investor, complete a block under 'Investors/Source of Funds'. Include their name, address, and amount invested. If there are more than two investors, use an attached rider as necessary.
Finally, ensure that you sign and date the affidavit at the bottom of the form to certify its accuracy.

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