Liquor License Refund_James GoetzingerDate: ~~'X~ ~~ o~~/ /
To The Honorable Mayor
and City Council
Dubuque, Ia. 52001
ilear Council Members:
I am hereby requesting a refund on BEER & LIQUOR COMBINATION LICENSE,
License No. ~-~~~ ~b~ ~ issued on j~~~-,~ ~ ~_ ~ 0~ and
expiring ~~ ~-~~1-~ ~, ~~,G f (~ . I discontinued business on
G~
- ~g~v~K~ ~~, and respectfully request your Honorable
Body to grant me a refund of ~~,~
Respectfully Submitted,
Name ~
D/B/A
Addr ss f Busi es
Federal Tax # or Social Security #
MAIL HECK TO:
~ItlNIES ~ ~'O~T.~Pi.~G~i~
~-`T 3 ~ ~'~~ ~ t
v " v~ ~~~R ~~~~
- ALCOHOLIC
B EVE RAGES Chester J. Culver
DIVISION ~;~`~~~~ ~~y,,!_udge
State of Iowa Lynn M. 'W~-a~/Iding
(39 APR 23 Psi 12~ 0~
City ~,:. _ _. v? ~ icG
Apri124, 2009 C?iJ~}~~!^{.''~', '~'`~;
Goetzinger, James W.
2776 Jackson Street
Dubuque, IA 52001-0000
RE: LICENSE /PERMIT No. LC0016530
Dear Licensee / Permittee:
Governor of Iowa
Lieutenant Governor
Administrator
Enclosed is a state warrant in the amount of $1183 which was issued in payment of a refund
on your Class C Liquor License (LC) (Commercial).
pleas apply to the CITE L GOI~NTY ~r their p~rtian.af tl~e ~ in tl~ amount. of $~45
Licensing Section
Iowa Alcoholic Beverages Division
1918 SE Hulsizer
Ankeny, Iowa 50021
515.281.7400 (option 1)
T;,11 Pree 866.4rJ° ~~''~ (optio:: 1)
..~~~_
Enc.
cc: CITY CLERK /COUNTY AUDITOR
A Division of the Department of Commerce 11918 SE Hulsizer Road Ankeny, Iowa 50021-3941
Rh 515.281.7400 FAX 515.281.7375 TOLL FREE 866.IOwaABD WWW.IowaABD.com