Liquor License Refund_Ann CunninghamTo The Honorable Mayor
and City Council
Dubuque, la. 52001
Dear Council Members:
I am hereby requesting a refund on BEER & LIQUOR COMBINATION LICENSE,
License No. L coo 3 5 2 X issued on Aid v 1 Zoo and
expiring (V v 12 . L o) o . I discontinued business on
and respectfully request your Honorable
Body to grant me a refund of . 50 .
Respectfully Submitted,
Name
D /B /A
r 74,'y1
Address of Business
1/
Federal Tax # or Social Security #
Date:
Jo
MAIL CHECK TO:
5 t /y / ch n "v
June 16, 2010
920 Main dbq, Inc
920 Main Street
Dubuque, IA 52001
ALCOHOLIC
BEVERAGES
DIVISION
State of Iowa
Dear Licensee / Permittee:
Licensing Section
Iowa Alcoholic Beverages Division
1918 SE Hulsizer
Ankeny, Iowa 50021
515.281.7400 (option 1)
Toll Free 866.469.2223 (option 1)
Enc.
cc: CITY CLERK / COUNTY AUDITOR
A Division of the Department of Commerce
al.:. LICENSE / No. LC0036524
Chester J. Culver
Patty Judge
Stephen Larson
Governor of Iowa
Lieutenant Governor
Administrator
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
C-
C
is
1918 SE Hulsizer Road Ankeny, Iowa 50021 -3941
PH 515.281.7400 FAX 515.281.7385 TOLL FREE 866.lowaABD WWW.lowa ABD.com
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