NANJING_REDACTED.PDF

Maricopa County — Formal (2022-07-27)

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State of Arizona

Department of Liquor Licenses and Control

Created 06/01/2022 @ 01:20:53 PM

Local Governing Body Report

LICENSE

Number: 12071674 Type: 012 RESTAURANT
Name: NANJING
State: Pending
Issue Date: Expiration Date: 03/3 1/2023
Original Issue Date: 10/10/1990
Location: 13606 W CAMINO DEL SOL

STE 101

SUN CITY WEST, AZ 85375

USA
“_ P|
Alt. Phone:
Currently, this license has pending applications.

AGENT

Name: CHO] JONG TAN KUANG

Gender: Female
Correspondence Address:

SA

Phone:
Alt. Phone:
Email:

"

OWNER

Page | of 3

Name: NANJING RESTAURANT, INC
Contact Name: CHOI] JONG TAN KUANG
Type: LIMITED LIABILITY COMPANY
AZ CC File Number: 07026818 State of Incorporation; AZ
Incorporation Date: 10/01/1993
Correspondence Address: P|
USA
Phone:

Alt. Phone:

Officers / Stockholders

Name: Title: % Interest:
GENE LOY TAN President 50.00
CHOI] JONG TAN KUANG Treasurer 50.00

NANJING RESTAURANT, INC - President

Name: GENE LOY TAN
Gender: Male

Correspondence Address:

Phone:
Alt. Phone:
Email:
NANJING RESTAURANT, INC - Treasurer
Name: CHOI] JONG TAN KUANG
Gender: Female

Correspondence Address:

Phone:
Alt. Phone:
Email:

Page 2 of 3

APPLICATION INFORMATION

Application Number: 197230
Application Type: Acquisition of Control
Created Date: 05/05/2022

QUESTIONS & ANSWERS

012 Restaurant

3) Have you submitted questionnaires? Each person listed must submit a questionnaire and mail in a
fingerprint card along with a $22. processing fee per card.
Yes
4) Does the Business location address have a street address for a City or Town but is actually in the
boundaries of another City, Town or Tribal Reservation?
No

"ee MAY 4 ANDO GFPLLC

Nanjing Restaurant Inc.
13606 Camino Del Sol Ste. 101
Sun City West, AZ 85375

April 8, 2022
Arizona Department of Liquor Licenses and Control
800 W. Washington 5" Flr

Phoenix, AZ 85007-2934

As of May 1, 2022, Zhen Lian Tan’s fifty percent share of Nanjing will be sold to Choi
Jong Kuang.

Choi Jong Kuang will take Zhen Lian Tan’s place and act as agent for Nanjing’s liquor
license, license number12071674.

Sincerely,

ZL Zz

Gene Loy Tan
Controlling Person

Zhen Lian Tan
Agent/Controlling Person

hd QP boa

Choi“To! ee g)
New Agent/Controlling-Pétson

AZDLLE

Arizona Department of Liquor Licenses and Control
800 W Washington 5t* Floor
Phoenix, AZ 85007-2934
www.azliquor.gov
(602) 542-5141

QUESTIONNAIRE
A.R.S.§ 4-202, 4-210
Type or Print with Black Ink

-1- i . —
The fees allowed by R19-1-102 will be charged for all dishonored checks. SVS | SoA

ATIENTION APPLICANT: This is a legally binding document. Please type or print in black Ink. An investigation of your
background will be conducted. Incomplete applications will not be accepted. False or misleading answers may result in the
denial or revocation of a license or permit and could result in criminal prosecution.

Attention local governments: Social security and birth date information is confidential. This information may be given to law
enforcement agencies for background checks only.

QUESTIONNAIRE IS TO BE COMPLETED BY EACH CONTROLLING PERSON, AGENT AND MANAGER BEING DISCLOSED TO THE DEPARTMENT. EACH
PERSON COMPLETING THIS FORM MUST SUBMIT A BLUE OR BLACK LINED FINGERPRINT CARD ALONG WITH A $22 FEE. FINGERPRINTS MUST BE DONE
BY A LAW ENFORCEMENT AGENCY OR BONA FIDE FINGERPRINT SERVICE. FOR AN ADDITIONAL $13 FEE, FINGERPRINTS MAY BE DONE AT THE
DEPARTMENT OF LIQUOR WHEN ACCOMPANIED BY A COMPLETED APPLICATION. / 4 F 8 dS

Liquor License#: _/207/074 /

1, Check the

Appropriate

Box is [Xl controlling Person [Agent [Premises Manager
(complete all questions except #12)

. ~ — Cr
2. Name: Kane Che \onw \ ON Birth ot
Last -} First = ‘Middle ‘a public recor
3. Social Security i Driver uicense- State: AZ

4, Place of birth: a ines L li yen Height: 5B" Weight: LBL lbs Eyes: Bran Hair Quy L. Zrwiy Bhd
ch =~

State COUNTRY (not county)

5. Name of current/most recent spouse: VaT AG Prxi H, At Birth cote
last 3 First ‘Middle 'G public recor

6. Are you a bona fide resident of Arizona? hes Cho If yes, what is your date of residency: 2/7 14S§

7. Daytime telephone —_ ff E-mail address}

8. Business Name: Naw Ve co Business Phone: 673/.S8¢ / (S&S
9. Business Location Address; /260b  Camine Del Sol Ste lel Sun Cit Ly bales! . AZ NMaricopes 85375"
City Ip

Street (do nat use PO Box ) State" ‘ounty ii

10. List your employment or type of business during the past five (5) years. if unemployed, retired, or student, list residence address.

FROM TO EMPLOYERS NAME OR NAME OF BUSINESS
Month/Year Month/Year DESCRIBE POSITION OR BUSINESS

04/2022. | cure _|Qwner (Treasurer
62/2003 | 03/2022 | Ovaec / Teeosarer

{ATTACH ADDITIONAL SHEET IF NECESSARY)

1/11/2018 Page 1 of 2
Individuals requiring ADA accommodations please call (602}542-2999

11, Provide your residence address information for the last five (5) years: A.R.S. §4-202/(D)

"CeMAY 4 ANLLGL AZDLLO

FROM TO
Month/Year Month/Year RESIDENTIAL Street Address

(ATTACH ADDITIONAL SHEET IF NECESSARY)

12. As a Controlling Person or Agent, will you be physically present and operating the licensed premises? [Aves[_No
If you answered YES, then answer #13 below. If NO, skip to #14.

13. Have you attended a DLLC approved Basic & Management Liquor Law Training Course within the past 3 Brgy
years?

14. Have you been cited, arrested, indicted, convicted, or summoned into court for violation of ANY criminal CesKNo
law or ordinance, regardless of the disposition, even if dismissed or expunged, within the past five (5) years?

15. Are there ANY administrative law citations, compliance actions or consents, criminal arrests, indictments or Cves{KNo

summonses pending against you? (Do not include civil traffic tickets.) A.R.S.§4-202,4-210

16. Has anyone EVER obtained a judgement against you the subject of which involved fraud or misrepresentation? Ceo

17. Have you had a liquor application or license rejected, denied, revoked or suspended in or outside of Arizona CesNo
within the last five years? A.R.S.§4-202(D)

18. Has an entity in which you are or have been a controlling person had an application or license rejected,
denied, revoked or suspended in or outside of Arizona within the last five years? A.R.S.§4-202(D)

If you answered “YES” to any Question 14 through 18 YOU MUST aitach a signed statement.
Give c lete detalls including dates, agencies involved and disposttions.

CHANGES TO QUESTIONS 14-18 MAY NOT BE ACCEPTED

NOTARY

\ ; ,
| (Print Full Name) Ch é { bn KOHL hereby declare that | am the Agent/ Controlling Person /

Premises Manager filing this Spplicatién. \ have read tls document and verify the contents and all statements are true,
correct and complete, to the best of my knowledge.

The foregoing instrument was acknowledged befére me this

My Commission Expires on: nis] t t 24 Day of Avo | , 2022

Day i Year

Signature: (ha Ap ious kre of Arizona county of_ Masi cope

& f 7
1 5

7 7

The Licensee has authorized the person named on this questionnaire to act as manager for the above License.

PRINTNAMECA/EX LIAM TAY SIGNATURE: 2#c~- eK To~

1/11/2018 Page 2 of 2
Individuals requiring ADA accommodations please call (602)542-2999