______________________________________________________________________________
Date _____
I am 18 years of age or over.
Signature
Evidence in support of age and identity:
Driver’s License No._____ (_____)
State
Military Record No._____
Liquor Permit No._____
Other _____
(Fill in license or card number of any one or
more of above)
______________________________________________________________________________
(2) A licensee who, in good faith and with reasonable cause to believe in its truth, accepts a written statement of age, as provided in subsection (1) of this section, may rely on the truth of the statement as conclusive evidence of the age of the person by whom it is signed.
(3) No person shall make a statement of age, as provided in subsections (1) and (2) of this section, that is false in whole or in part, or produce any evidence that would falsely indicate his or her age. [1957 c.313 §§18,19; 1973 c.827 §46]
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