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1 Address: <br /> 2 Address or location where keg will be located: <br /> 3 <br /> 4 Motor Vehicle Operator's License Number: <br /> 5 Washington State Identification Card: <br /> 6 Other Identification: <br /> 7 I declare under penalty of perjury the information provided in this receipt <br /> is true and correct and that I am over the legal age to purchase, possess <br /> 8 or use malt liquor, that I will not allow the malt liquor purchased and <br /> identified by this receipt to be consumed by any person who is under the <br /> 9 age of twenty-one (21) except as provided by RCW 66.44.270, and that I <br /> will not remove or obliterate the numbered identification label affixed to <br /> 10 the container. <br /> 11 <br /> Signature of Purchaser <br /> 12 <br /> Identity of Seller: <br /> 13 <br /> Address of Licensed Premises: <br /> 14 <br /> 15 NOTICE <br /> 16 It is unlawful for any person under the age of twenty-one (21) years to <br /> acquire in any manner, consume or have in his or her possession, any <br /> 17 intoxicating liquor, provided that the foregoing shall not apply in the case <br /> of liquor given or permitted to be given to such person under the age of <br /> 18 twenty-one (21) years by his parent or guardian for beverage or medicinal <br /> purposes in the home or administered to him by his physician or dentist <br /> 19 for medicinal purposes. A person who signs this receipt with knowledge <br /> that any information in the receipt is false commits perjury. Violations of <br /> 20 any of the provisions of the City of Everett ordinance which requires this <br /> statement and these terms is a misdemeanor punishable by a fine of not <br /> 21 more than $1,000, or by imprisonment not to exceed ninety (90) days, or <br /> by both such fine and imprisonment. <br /> 22 <br /> 23 10.43.040 Penalty. <br /> 24 The violation of any provisions of this chapter shall be a misdemeanor. <br /> 25 <br /> Section 2: Severability. If any section, sentence, clause or provision of this <br /> 26 <br /> ordinance should be held to be invalid or unconstitutional by a court of competent <br /> 27 <br /> jurisdiction, such holding shall not affect the validity or constitutionality of any other <br /> 28 <br /> section, sentence, clause or phrase of this ordinance. <br /> 29 <br /> Section 3: General Duty. Nothing in this ordinance is intended to create a <br /> 30 <br /> cause of action or claim against the City or its officials or employees running to <br /> 31 <br /> 32 <br /> 3 <br />