Withdraw Of Registration
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Withdraw Of Registration Form. This is a Illinois form and can be use in Liquor Control Commission Statewide.
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Tags: Withdraw Of Registration, IL 567-0030, Illinois Statewide, Liquor Control Commission
ILLINOIS LIQUOR CONTROL COMMISSION
WITHDRAW OF REGISTRATION
, does hereby
(Manufacturer, Distributor or Importing Distributor)
withdraw from
(Distributor)
its registration dated
granting the right to sell or distribute at wholesale at any location within the State of Illinois, the following alcoholic liquors which bear trademarks, brands or names owned or controlled by
(Manufacturer, Distributor or Importing Distributor)
License #
Corporate Name:
Expires
Address:
(Street - Number)
Date:
(City or Town)
Signed By:
IL 567-0030 (10/2005)
Printed on Recycled Paper
(Title)
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