Form ABC-243 "Corporate Questionnaire" - California

What Is Form ABC-243?

This is a legal form that was released by the California Department of Alcoholic Beverage Control - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2019;
  • The latest edition provided by the California Department of Alcoholic Beverage Control;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form ABC-243 by clicking the link below or browse more documents and templates provided by the California Department of Alcoholic Beverage Control.

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Download Form ABC-243 "Corporate Questionnaire" - California

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Department of Alcoholic Beverage Control
State of California
Gavin Newsom, Governor
CORPORATE QUESTIONNAIRE
Instructions: Complete all items. One officer must sign for the corporation. Item 16 - List Certificates chronologically, including
active, canceled, and pending issuance. If stock is pledged, include date, number of shares, and from whom to whom.
1. NAME OF CORPORATION
2. ABC LICENSE NUMBER
3. PREMISES ADDRESS
4. TELEPHONE NUMBER
5. ATTORNEY'S NAME
6. ATTORNEY'S TELEPHONE NUMBER
7. ATTORNEY'S ADDRESS
8. NAME OF BANK (Corporate account)
9. ACCOUNT NUMBER
10. ADDRESS OF CORPORATE BANK ACCOUNT
11. PERSONS AUTHORIZED TO SIGN ON BANK ACCOUNT (Print)
12. INCORPORATION DATE
13. STATE OF INCORPORATION
14. SECRETARY OF STATE FILE NUMBER
15. OFFICERS AND DIRECTORS
TITLE
NAME
ADDRESS
TELEPHONE NUMBER
TITLE
NAME
ADDRESS
TELEPHONE NUMBER
TITLE
NAME
ADDRESS
TELEPHONE NUMBER
TITLE
NAME
ADDRESS
TELEPHONE NUMBER
TITLE
NAME
ADDRESS
TELEPHONE NUMBER
TITLE
NAME
ADDRESS
TELEPHONE NUMBER
16. LIST ALL STOCK CERTIFICATES
PERCENTAGE OF
CERTIFICATE
NUMBER
OUTSTANDING
DATE
DATE
TO WHOM ISSUED
NUMBER
OF SHARES
SHARES OF STOCK
ISSUED
CANCELED
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
Continued on reverse
I hereby certify the above are the present officers, directors and/or stockholders and that each such officer, director and stockholder is the real party in interest
with respect to his/her position and is not acting directly or indirectly as an agent, employee or representative of any other person not reported to the
Department. The provisions of sections 23405 and 23405.3 of the Business and Professions Code (B&P) are hereby acknowledged and it is understood that
changes within the corporation and/or entities holding interest in the corporation will be reported to the Department as required by Rule 68.5 CCR and a fee
may be required pursuant to Sections 24071.1 & 24072 B&P.
SIGNATURE (FOR THE CORPORATION)
TITLE
DATE SIGNED
ABC-243 (rev. 07/19)
Department of Alcoholic Beverage Control
State of California
Gavin Newsom, Governor
CORPORATE QUESTIONNAIRE
Instructions: Complete all items. One officer must sign for the corporation. Item 16 - List Certificates chronologically, including
active, canceled, and pending issuance. If stock is pledged, include date, number of shares, and from whom to whom.
1. NAME OF CORPORATION
2. ABC LICENSE NUMBER
3. PREMISES ADDRESS
4. TELEPHONE NUMBER
5. ATTORNEY'S NAME
6. ATTORNEY'S TELEPHONE NUMBER
7. ATTORNEY'S ADDRESS
8. NAME OF BANK (Corporate account)
9. ACCOUNT NUMBER
10. ADDRESS OF CORPORATE BANK ACCOUNT
11. PERSONS AUTHORIZED TO SIGN ON BANK ACCOUNT (Print)
12. INCORPORATION DATE
13. STATE OF INCORPORATION
14. SECRETARY OF STATE FILE NUMBER
15. OFFICERS AND DIRECTORS
TITLE
NAME
ADDRESS
TELEPHONE NUMBER
TITLE
NAME
ADDRESS
TELEPHONE NUMBER
TITLE
NAME
ADDRESS
TELEPHONE NUMBER
TITLE
NAME
ADDRESS
TELEPHONE NUMBER
TITLE
NAME
ADDRESS
TELEPHONE NUMBER
TITLE
NAME
ADDRESS
TELEPHONE NUMBER
16. LIST ALL STOCK CERTIFICATES
PERCENTAGE OF
CERTIFICATE
NUMBER
OUTSTANDING
DATE
DATE
TO WHOM ISSUED
NUMBER
OF SHARES
SHARES OF STOCK
ISSUED
CANCELED
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
Continued on reverse
I hereby certify the above are the present officers, directors and/or stockholders and that each such officer, director and stockholder is the real party in interest
with respect to his/her position and is not acting directly or indirectly as an agent, employee or representative of any other person not reported to the
Department. The provisions of sections 23405 and 23405.3 of the Business and Professions Code (B&P) are hereby acknowledged and it is understood that
changes within the corporation and/or entities holding interest in the corporation will be reported to the Department as required by Rule 68.5 CCR and a fee
may be required pursuant to Sections 24071.1 & 24072 B&P.
SIGNATURE (FOR THE CORPORATION)
TITLE
DATE SIGNED
ABC-243 (rev. 07/19)
LIST ALL STOCK CERTIFICATES (Continued from other side)
PERCENTAGE OF
CERTIFICATE
NUMBER
OUTSTANDING
DATE
DATE
TO WHOM ISSUED
NUMBER
OF SHARES
SHARES OF STOCK
ISSUED
CANCELED
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
ABC-243 (rev. 07/19)
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