§ 95. Information to be requested in applications for licenses. 1. The
board may specify the manner and form in which an application shall be
submitted to the board for licensure under this article.

2. The board may adopt regulations establishing what relevant
information shall be included on an application for licensure under this
article. Such information may include, but is not limited to:
information about the applicant's identity; ownership and investment
information, including the corporate structure; evidence of good moral
character; financial statements; information about the premises to be
licensed; information about the activities to be licensed; and any other
relevant information specified in regulation.

3. All license applications shall be signed by the applicant if an
individual, by a managing partner if a limited liability company, by an
officer if a corporation, or by all partners if a partnership. Each
person signing such application shall verify it as true under the
penalties of perjury.

4. All license applications shall be accompanied by a check, draft or
other forms of payment as the board may require or authorize in the
reasonable amount required by this article for such license.

5. If there be any change, after the filing of the application or the
granting, modification or renewal of a license, in any of the material
facts required to be set forth in such application, a supplemental
statement giving notice of such change, duly verified, shall be filed
with the board within ten days after such change. Failure to do so, if
willful and deliberate, may be grounds for revocation of the license.