Refund, Beer - Family BeverageDate: March ~o, ~o01
To The Honorable Mayor
and City Council
Dubuque, Ia. 52001
Dear Council Members:
I am hereby requesting a refund on CLASS (~/ BEER PERMIT
License No. ~O0~¢~q , issued on Au:~N$± 01~ S[OOOand
expiring duly ~i~ ~OOI ,. I discontinued business on
M~Fo~t~ O~ ~ug~)l and respectfully request you Honorable Body to
!
grant me a refund of 7~'?
Respectfully Submitted,
Name
D/B/A J
..,Z~oO ee~cr~ l--
Address of Business
Federal Tax # or Social Security #
MAIL CHECK TO:
To The Honorable Mayor
and City Council
Dubuque, Ia. 52001
Date:
Dear Council Members:
t am hereby requesting a refund on CLASS ~ BEER PERMIT
License No. ~Oo~C){o.B , issued on AmjNsf Ol~ ~O00and
expiring dutx/ ~t~ ~,Od) l I discontinued business on
M~lFr~h O~,refund~l_~ and r~_~ectfully request you Honorable Body to
grant me a ot~P' 7~' ·
Respectfully Submitted.
Name
D/B/A ~ J
Address of Business
Federal Tax ¢ or Social Security ¢
MAIL CHECK TO:
STATE OF
THOMAS d. VI LSACK
GOVERNOR
SALLY J. PEDERSON
LT. GOVERNOR
DEPARTMENT OF COMMERCE
ALCOHOLIC BEVERAGES DIVISION
May25,2001
Family Beverage Center Dubuque Inc
3400 Central Ave,
Dubuque, IA 520010000
Dear Licensee/Permittee:
RE: License/Permit No. BC0026063
Enclosed is state warrant in the amount of $15.00 which was issued in payment Ora
refund on your Beer Permit Class C permit.
Please apply to the CITY/COUNTY for their portion of the refund in the amount of
$75.00.
Very truly yours,
Karen Freund
Administrative Assistant
Eric.
cc: CITY CLERK/COUNTY AUDITOR
1918 S.E. HUL$1ZER RD. /ANKENY, IOWA 5OO21-3941 /515-281-7400
www. lowaABD.com