Affidavit Of Posting - Arizona Department Of Liquor Licenses And Control
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1Arizona Department of Liquor Licenses and Control
800 W Washington 5th Floor
Phoenix, AZ 85007-2934
(602) 542-5141
AFFIDAVIT OF POSTING
Date of Posting: ____________________________________
Date of Posting Removal: ___________________________________
Applicant’s Name: ____________________________________________________________________________________________________
Last
First
Middle
Business Address: ______________________________________________________________________________________________________
Street
City
Zip
License #: __________________________________________
I hereby certify that pursuant to A.R.S. 4-201, I posted notice in a conspicuous place on the premises proposed to be
licensed by the above applicant and said notice was posted for at least twenty (20) days.
___________________________________________________________ ________________________
________________________________
Print Name of City/County Official
Title
Phone Number
______________________________________________________________________________________ ________________________________
Signature
Date Signed
Return this affidavit with your recommendations (i.e., Minutes of Meeting, Verbatim, etc.) or any other related documents.
If you have any questions please call (602) 542-5141 and ask for the Licensing Division.
8/21/2015
Page 1 of 1
Individuals requiring ADA accommodations please call (602)542-9027
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