Liquor License Refund_White House
Dater' ~~l)
To The Honorable Mayor
and City Council
'~ubuque, Ia. 52001
Dear Council Members:
I am hereby requesting a refund on BEER & LIQUOR COMBINATION LICENSE,
License No.I C O b ~? ~~ S ~ ~, issued on ~ - J - ~(J / ~d
expiring ' } -L~' -(> ~f I discontinued business on
,C~. ,~ ~f - ~~C and respectfully request your Honorable
Body to grant me a refund of ~ ~~ -
Respectfully Submitted,
D/B/A
_._
~_
Federal Tax # or Social Security #
MAIL C CK
~~ u
S ~~
~~
~S~Db~
ALCOHOLIC
BEVERAGES
DIVISION
State of Iowa
June 17, 2009
Mary A. Hoffman
450 W Locust
Dubuque, IA 52001
L39 JUr~ 23 ~M 8~ 18
City ~I<.:. ~ UiilC~
DLi ~:,t~! rt.. f~~
Chester J. Culver Governor of Iowa
Patty Judge Lieutenant Governor
Lynn M. Walling Administrator
RE: LICENSE /PERMIT No. LC0036571
Dear Licensee / Permittee:
Enclosed is a state warrant in the amount of $422.5 which was issued in payment of a refund
on your Class C Liquor License (LC) (Commercial).
Please apply to the CITY /COUNTY for their portion of the refund in the amount of $422.5
Licensing Section
Iowa Alcoholic Beverages Division
1918 SE Hulsizer
Ankeny, Iowa 50021
S i ~.281.74GC (option 1)
Toll Free 866.469.2223 (option 1)
Enc.
cc: CITY CLERK /COUNTY AUDITOR
1918 SE Hulsizer Road Ankeny, Iowa 50021-3941
A Division of the Department of Commerce
PH 515.281.7400 Fax 515.281.7385 TOLL FREE 866.IOwaABD WWW.IowaABD.com
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