N.J. Admin. Code § 13:69A-5.7

Current through Register Vol. 56, No. 21, November 4, 2024

Section 13:69A-5.7 - Business Entity Disclosure Form-Casino Hotel Alcoholic Beverage Enterprise

(a) A Casino Hotel Alcoholic Beverage Enterprise Business Entity Disclosure Form (CHAB BED) shall be in a format prescribed by the Division and may require the applicant to provide the following information:

1. Any official or trade name used by the applicant for the last five years;

2. Whether the application is for initial licensure or submission for retention of the license and, if for retention, the license number of the current license;

3. The name, title and telephone number of a person to be contacted in reference to the application;

4. The current or former business addresses of the applicant enterprise for the last five years;

5. The current telephone and fax number of the applicant enterprise;

6. The business form of the enterprise, and a copy of the certificate of incorporation, charter, bylaws, partnership agreement, trust agreement or other basic documentation of the enterprise;

7. If the enterprise is a publicly traded corporation, the exchange its stock is traded on and its symbol;

8. The nature of the applicant's business, and the type of goods and services being provided to the casino industry;

9. The Federal Employer Identification Number or Social Security Number of the owner;

10. The following information regarding agreements with any casino licensee or applicant:

i. The number of written agreements entered into and a sample copy of such an agreement;

ii. The terms of any unwritten agreements or purchase order agreements with casino licensees or applicants, including the expected duration and compensation; and

iii. Whether any such agreements are in any way subject to or conditioned upon any other agreement between the casino licensee or applicant and the applicant or any other enterprise, or upon other agreements between the applicant and its suppliers, vendors or subcontractors, and the facts related thereto;

11. Any suppliers, vendors or subcontractors of the applicant which are also securities holders or creditors of the applicant;

12. The name and location of any government agency in this State or any other jurisdiction that regulates the applicant, and the nature and extent of regulation;

13. During the last five-year period, whether the applicant has had any license or certificate denied, suspended or revoked by any government agency in this State or any other jurisdiction, the nature of such license or certificate, the agency and its location, the date of such action, the reasons therefor and the facts related thereto;

14. The following financial information:

i. Two copies of the applicant's most recent financial statement whether audited or unaudited, the auditor's report and Federal and state tax returns;

ii. During the last five-year period, information regarding any judgments or petitions for bankruptcy or insolvency and any relief sought under any provision of the Federal Bankruptcy Act or any state insolvency law; and any receiver, fiscal agent, trustee or similar officer appointed for the applicant's property or business;

15. Civil, criminal, administrative and investigatory proceedings in this State, or any other jurisdiction, as follows:

i. Information regarding any indictment, charge or conviction for any criminal or disorderly persons offense;

ii. Any criminal proceeding in which the applicant has been a party or has been named as an unindicted co-conspirator;

iii. Any judgment, order, consent decree or consent order entered against the applicant pertaining to a violation or alleged violation of the Federal antitrust, trade regulation or securities laws or similar laws of any jurisdiction; and

iv. During the past 10 years, any judgment, order, consent decree or consent order entered against the applicant pertaining to a violation or alleged violation of any other state or Federal statute, regulation or code which resulted in the imposition of a fine or penalty of $ 50,000 or more;

16. The name, home address, date of birth, title or position and percent of ownership, where applicable, of each of the following persons or entities:

i. Any officer, inside director, trustee, partner or sole proprietor;

ii. Each enterprise or natural person that directly holds any beneficial or ownership interest of five percent or more of the applicant;

iii. Each sales representative or other person who regularly solicits business from a casino licensee or applicant, such person's immediate supervisors and all persons responsible for the office out of which such supervisors work; and

iv. Any person authorized to sign any agreement with a casino licensee or applicant; and

17. A copy of a business registration certificate or other proof of valid business registration with the Division of Revenue in the New Jersey Department of the Treasury.

(b) In addition to the information in (a) above, a completed CHAB BED may include the following:

1. A certification of truth, which shall be dated, notarized and signed by the following:

i. If the applicant is a corporation, the president or any other authorized officer;

ii. If the applicant is a partnership, each partner;

iii. If the applicant is a limited partnership, each general partner;

iv. If the applicant is a sole proprietorship, the sole proprietor; or

v. If the applicant is any other business form, any authorized officer;

2. A Release Authorization directing all courts, probation departments, selective service boards, employers, educational institutions, banks, financial and other institutions and all governmental agencies, Federal, state and local, both foreign and domestic, to release any and all information pertaining to the applicant as requested by the Division, which shall be dated, notarized and signed by the following:

i. If the applicant is a corporation, the president or any other authorized officer;

ii. If the applicant is a partnership, a partner;

iii. If the applicant is a limited partnership, a general partner;

iv. If the applicant is a sole proprietorship, the sole proprietor; or

v. If the applicant is any other business form, any authorized officer; and

3. An acknowledgment of receipt of notice regarding confidentiality, consent to search and nonrefundability of filing fees, which shall be dated, notarized and signed in accordance with (b)2i through v above.

N.J. Admin. Code § 13:69A-5.7