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FI230 (2/2006)1. Check one:2. Check one:FOOD SERVICE LICENSE APPLICATIONFixed EstablishmentRenewal License ApplicationMobileNew Owner Mobile Commissary Est. Or New LocationVending Location: # of machines
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i certify that this is a statement confirming that the information provided is true and accurate to the best of the signer's knowledge.
Anyone who is submitting a document or application that requires a statement of truth or accuracy may be required to file i certify that this.
To fill out i certify that this, the individual must read the statement and sign/date it to confirm the accuracy of the information provided.
The purpose of i certify that this is to ensure that the information being submitted is accurate and true, and to hold the signer accountable for the content of the document.
The information reported on i certify that this typically includes a statement affirming the accuracy of the information provided in the accompanying document.
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