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RES 2013-0355 - Appoint Alphonse Bakhit manager of A B's 66 Application for Corporate Manager RECEIVED f. *Must Be A Nebraska Resident" Please subntit,in Triplicate • APR 1 1 204 Return to: Nebraska Liquor Control Commission,PO Box 95046 301 Centennial Mall So.,Lincoln NE 68509 NEBR'ASI(AUQUOR Phone:(402)471.2571 Fax:(402)471.2814 Web address:lutp://www.00Lorg/bome/NLCC/CONTROLCOMMISMN s. s , xe '�Ytgb ! F y�+r', 7,x4�f � x� iS! i 2 : r�2 y• t '4'. ,.�: � .� 2. µs.*4 .. .•,Si,,k•- .;` r.:. ;d 4$4•.4, 9.1:' . ^+^/ � ,: '4. let? !`•, NAME OF LICENSED CORPORATION CLASS&LICENSE NUMBER /7,3. s 6 4 -I)t4.do— Pa co.. - S<ys2,1' TRADE NAME OF LICENSED PREMISE �.a S 44 STREET ADDRESS OF LICENSED PREMISE CITY I COUNTY ZIP CODE • / 49Lb l t tewi /�-�.-- �r.}h�.�-,--- Doug/a:t.S 6 S?/3 On behalf of the corporation,I designate this individual as corporate manager. Signature of Corporate President/CEO: A a �'ri � f::�� w � ✓.�Y�k ' �H :y�kv � .; y � 4 3{•'.�ih y�fi4 + '1M�•iS;.ct z � < ;Aa � �`. --.!!1.�3.d�.'c� ,�.a.� r 4' / .Q4 .tt £F .. 3 • NAME(LAST,FIRST,MIDDLE,MAIDEN) SEX SOCIAL SECURITY NUMBER DATE OF BIRTH PLACE OF BIRTH �4 eiti4, /9�/{av►S�. tIh 1 F HOME STREET ADDRESS CITY COUNTY STATE ZIP CODE 3s-/8' Zccrf' Orr, ►- Doles/4s Nc. 6ea./ HOME TELEPHONE NUMBER BUSINESS TELEPHONE NUMBER DRIVERS LICENSE NUMBER&.STATE (ties) SW. Cr 7-541-- J (Va ) 'i.. ; .. ._.a t N • y e � �f'.f c '�>'' ° 4. .,hY C ,�� h3� �N+" "'b.�L" `£" .. � -•$• # ,X,F3$ d� % '� �a, � , � � �i£�,,& � � �fj ,,��++��A p.t. .+�,.,•�'%.,. t: l'3xv.s•% „W. tic # �� '�;-. .. �.<fj .f � rs:... �. �� �" . , _ • �, s ��� ;s as �fc.�,k�fi�„0 .a FULL NAME(LAST,FIRST,MIDDLE,MAIDEN) SOCIAL SECURITY NUMBER DRIVERS LICENSE NUMBER Ii &STATE • DATE OF BIRTH: PLACE OF BIRTH • I. READ CAREFULLY. Answer completely and accurately. Has anyone who is a party to this application,or their spouse,ever been convicted of or plead guilty to any criminal charge. Criminal charge means any charge alleging a felony or misdemeanor vi lii on of a federal or stale lbw:or a violation of a local law,ordinance or resolution. List the nature of the charge,where the charge occurred and the year and month of the conviction or plea. Also list any charges pending at the time of this application. If more than one party,please list charges by each individual's name. ( O Yes Cie 2. Have you or your spouse ever made application for any liquor license or manager for any liquor license? IF YES,for what premise give license number and date. DYES10 // 16531 { FORM 334013 REV 101 6001r mpflrl pow PACE I t i is • 3. Have you or or spouse ever made a compromise settlement for violation of such laws? DYES OFNO 4. Do you.as a manager,have all the qualifications required by any person entitled to hold a Nebraska Liquor License? N raska Liquor Control Act($53-131,01) YES ONO -- ... 5. Have you filed fingerprint cards and PROPER FEES(if chock,make out to the NE State Patrol),with this application? icitYLS ONO APPLICANT:CITY&STATE YEAR SPOUSE:CITY&STATE YEAR FROM TO FROM 'ft r9/Mon 04- /, &.r4 eh OrrnL,vs liffl_ 1111111111.= • , it.g:�' • •! :14 t ,s ? 2'*^ �iJ�l1[ 4.:f.Stn '�3a ': r „ ?'�[1 S.�V' YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER FROM TO oeirMnfl PIM 1 i� 3 a3` S r. as a a t Fes.'1� V x� e.lc. .N�i°i�.�ir�.:'arwt��• '� � �� £ f � ,i ,�g.�[,yy;j��}y, �.f�,.,�,rr�.,,�,� �.5�D Bi 1 �` o. 'V£-k.�t M::��iif.', w:..'H���' >7JG/.��rad"°<�.E STATE OF NEBRASKA ) ) SS COUNTY OF ) The above individual(s),being fast duly sworn upon oath.deposes and Watea that the undersigned is the applicant and/or spouse of applicant who makes the above and(c aseing appliation.that said application has born read and that the contents thereof and all statements contained therein are true. if any false statement is nude in any pan of this sppiicatio. the applican(s)shall be deemed guilty of perjury and subject to penalties provided by law.(Sec.553.131.01)Nebraska Liquor Control Apt. The undersigned applicant hereby consents to an investigation of his/her background including all records of every kind and description including police records.tax records(State and Federal),and bank or tending institution records,and said applicant and spouse waive any rigtda or wises of action that said applicant or spo..Ke may have against the Nebraska Liquor Control Ccmmisalon and any other indivihsal disclosing or releasing said information to the Nebraska Liquor Control Commission. If spouse has NO interest directly or indirectly,an s>fidasit of son participation may be attached. The undersigned understand andacknowledgethatanylicenseiswed,based on the information submitted hied:application.issubjecttocancellationiftheinfomwiuncontainedherein is incompkte and inaccurate. AMINIMMINENINIMIIIIIMMIIMMOMIMMOMMINIM ''' '''' '.4. .1.-'..#6'C'i '.. — Signature of Applicant Signature of Spouse(if appntxble) Subscribed in)ny prescs a and sworn to before me this As, Subscribed in my presence and sworn,to before me this day of Syr t•L_ O e•. _ day of _______ _.___. ' Nolan'EtgeataswSi tiled Notany•Stgsasu edr8:at --. , t; •_.r."_.-__- _..____. .a Lr!!-r... . I i+..r•, :3 'lE M WC.FOFAM 1 t rti ..".�1, MY Gomm SSIONEXPIRS +�r , ;,A::* ,,,phnmmber;A.2003 j FORat 334913 REV.1'01 PAGE 2 14y L �^ Onaho S �r�. � iJ'f' U.,: '�J l�� /r 1,t Q v' 1819 Farnam—Suite LC 1 _ 141�i Omaha, Nebraska 681 83-01 1 2 � Lister Brown (402) 444-5550 ®_� � . .4yf City clerk FAX (402) 444-5263 March 5, 2013 AB's 66 Dundee Place, Inc. Application to appoint Alphonse A. Bakhit Dba"A B's 66" manager of your present Package Liquor 4926 Underwood Avenue License location Omaha, NE 68132 Dear Liquor License Applicant: This letter is notification that a hearing before the Omaha City Council on your application to appoint a manager to the liquor license has been set for March 19, 2013 . The City Council Meeting begins at 2:00 P.M. in the Legislative Chamber, (LC-4), Omaha/Douglas Civic Center, 1819 Farnam Street, Omaha, Nebraska. City Council Liquor Rule No. 6 states, "Each applicant for any type of license shall be personally present in the Council Chambers, in order that the Council may make inquiries, on the date of public hearing of the application for said license". Failure to be present at this Council Meeting is grounds to recommend denial of your application to the Nebraska Liquor Control Commission. Sincerely yours, /64c$11 Buster Brown City Clerk BJB:clj d p ,a fJ dy}y] a � � 1.]! sue' fir- =7 v � �.� 6;d 9 F '.mam - a ufte LC 1 Omaha, Nebraska 68183-01 12 � L'IU8i6Vrow (402) 444-5550 Cep n OW:* 402 444-5263 March 5, 2013 Alphonse A. Bakhit Application to be appointed manager of the 3818 Burt Street present Package Liquor License location Omaha, NE 68131 for AB's 66 Dundee Place Inc., dba "A B's 66", 4926 Underwood Avenue Dear Liquor License Manager Applicant: This letter is notification that a hearing before the Omaha City Council on your application to be appointed manager of the liquor license has been set for March 19, 2013 . The City Council Meeting begins at 2:00 P.M. in the Legislative Chamber, (LC-4), Omaha/Douglas Civic Center, 1819 Farnam Street, Omaha, Nebraska. City Council Liquor Rule No. 6 states, "Each applicant for any type of license shall be personally present in the Council Chambers, in order that the Council may make inquiries, on the date of public hearing of the application for said license". Failure to be present at this Council Meeting is grounds to recommend denial of your application to the Nebraska Liquor Control Commission. Sincerely yours, 6 :d 2 Buster Brown City Clerk BJB:clj INTER-OFFICE COMMUNICATION March 4, 2013 TO: Irene Nelson, Police Records FROM: Carman Johnson, Liquor Clerk SUBJECT: Liquor Applications PLEASE RETURN BY: MARCH 7,2013 CITY COUNCIL HEARING DATE: MARCH 19,2013 AB'S 66 DUNDEE PLACE, INC 4926 UNDERWOOD AVENUE DBA A B'S 66 ALPHONSE BAKHIT, DOB 02/02/74, 3818 BURT STREET, OMAHA, NE 68131, SS #505- 98-0943,NE DRIVER'S LICENSE#V 00043358 No. 5 AB's 66 Dundee Place, Inc., dba "A B's 66", 4926 Underwood Avenue, requests permission to appoint Alphonse A. Bakhit manager of their present Package Liquor License location. 03-19-13;cj RECEIVED Presented to Council: March 19, 2013 - Approved 7-O Buster Brown City Clerk