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Arizona Department of Liquor Licenses antiCdittrai™ © 9 pic use ONLY https://www.azliquor.gov Job a AC \ A, (602) 542-5141 cahtads } caer APPLICATION WITHDRAWAL = NSN License #: License Number: Agent / Individual Name: Donde fson \\ (oc SN \J Last First Business Name: (oe Ong te (bee wl-tart a lexus Business Address: ioe “Dy Deven, fare s\n 1% Ch badlac a) 29295 Mailing Address: Us iS Ss Qaco\ (La Lem pe. ke “( “ YOIE2- - REASON FOR WITHDRAWAL (a . Fo luce =q_ Ug. plete olol vn pase of Wo OPP \.erdysc f- VaAnte DGD. Middle (USE BACK OF PAGE IF NECESSARY) Declaration: |, (Print Name) Only , declare under penalty of perjury that | am authorized by the licensee to submit this application. | have read the contents of this application and to the best of my knowledge believe all statements made on this application to be true, correct and complete. Signature REVIEW EMPLOYEE Customer Service Representative “ Ne Investigations (Pending Applications) Licensing Manager Liquor Board (Hearing files only) DISPOSITIONS C1 Letter Attached 0 intent to Halt CO Revoked-Order# D1 Application Denied D1 Reverted-Order# 11 Application Withdrawn 5/5/2025 LIC-GEN-WITHDR-001 Individuals reauirina ADA accommodations please call (4091542-2999