1. OWNER INFORMATION
- First and Lastname: Erin Faustin
Phone Number (Optional): 234-8770
Email (Optional): [email protected]
2. BUSINESS INFORMATION
- Name of Business: Pipe Down Cigars
Link to Registration: viewtopic.php?t=228920
Business Address: 34 Vespucci Blvd
Subsidiary Names (if applicable): N/A
Business Registration Type:
Mark an X in the appropriate checkbox.
[x] Stand-Alone
[ ] Subsidiary [Parent Company Name]
[ ] Parent
3. LICENSES APPLIED FOR
- Please note as a Parent Company, one license can be used for up to 2 Subsidiaries, but you can subscribe to multiple of the same type of license. If this applies to you, please mention how many subsidiaries need the license.
Please list all licenses you wish to apply for from the list HERE:
- LICENSE #1
License Name: GRBL:03 - Food & Drink Service
Subsidiary Names (if applicable): N/A
- LICENSE #2
License Name: GRBL:05 - Liquor
Subsidiary Names (if applicable): N/A
- LICENSE #3
License Name: GRBL:07 - Tobacco
Subsidiary Names (if applicable): N/A
- LICENSE #4
License Name: EEBL:02 - Event Organizer
Subsidiary Names (if applicable): N/A
- LICENSE #5
License Name: EEBL:04 - Raffles
Subsidiary Names (if applicable): N/A
- LICENSE #1
Vending Machine License (If applicable)
- Address of Vending Machine: Your answer here
Photo of Vending Machine: *ATTACHMENT*
4. AGREEMENT
- By submitting this request, you hereby agree that all information provided is truthful. You agree that you have read & understood all requirements, regulations and penalties related to the license(s) you are applying for. If your request is approved, you agree to a continuous effort to adhere to laws and regulations laid out by the San Andreas State Government. You also agree to submit any future changes to your business to the Business and Property Bureau. You also agree to a full legal background check of your person.
Owner's Signature: Erin Faustin
Date: 25/JUN/2026
