Withdrawal Form

City of Chandler — Regular Meeting (2024-09-12)

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APPLICATION WITHDRAWAL

Arizona Dept. of Liquor Licenses and Control
800 W. Washington St. 5" Floor Phoenix, AZ 85007
(602) 542-5141

Type or Print with Black Ink

License Number; JOB #301036

HOWARD CARLOS DEMETRUIS

Last Arst Middle
Premises Name (Doing Business As-DBA): SNEAKER HEADS

3002 N ARIZONA AVENUE #18 & 19 CHANDLER ARIZONA 85225

Street Clty State Lp Code
Mailing Address: 3002 N ARIZONA AVENUE #18 & 19 CHANDLER ARIZONA 85225

Agent / Individual Name:

Premises Address:

[==> REASON FOR WITHDRAWAL aa
RE-APPLYING FOR SERIES 06 LIQUOR LICENSE

(USE BACK OF PAGE IF NECESSARY)

Declaration:

CARLOS DEMETRUIS HOWARD

|, (Print Name) . declare under penalty of perury that | am
authorized by the licensee to submit this application. | have read the cone of this application, and to the best
of my knowledge believe all statements made on this a to wy iy i” ind complete.
z Signature
=a
REVIEW EMPLOYEE DATE
/ Customer Service Representative C Loy Q = \O oD at
\OO
Investigations (Pending Applications) o—— Y ghd naa 9 ) 10 / 20 24
Jennelen Fincen 09/10/24

Licensing Manager

Liquor Board (Hearing files only) ee

DISPOSITIONS

D Letter Attached 1 Intent to Halt

D Revoked-Order# ee OApplication Denied #
D Reverted-Order# _ DApplication Withdrawn

== ee

11/22/2022
individucls requiring ADA accommadatrions please call (402)542-2999