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Get and Sign Abl 20 2019-2022 Form
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PERSON FILING THE PROTEST
Name
Daytime phone number
Home address (no PO box)
City
County
State
ZIP
Mailing address
City
State
Email
Fax number (if applicable)
Do you live in the same county and/or within five miles of the location you are protesting?
ZIP
Yes
No
REQUIRED:
I will attend a contested case hearing before the Administrative Law Court and offer testimony as to why I believe
the location listed in this protest should not be issued a new beer and wine permit...
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