Addendum for Retail Alcohol License Renewal or Ownership Update Applications

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As the local authority, the City of Davenport has the responsibility of approving all retail alcohol licenses before issuance by the State of Iowa Alcoholic Beverages Division. It takes approximately 45 days to process a retail alcohol license application from the time all required documents are received by the City of Davenport until the license certificate is issued by the State of Iowa. The licensee shall complete an Application Addendum annually.

* Denotes a required field

BUSINESS INFORMATION

Application Type*
 
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Business Phone Number*
-- ext
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ZIP*
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Second portion of ZIP Code is optional.
Phone Number*
-- ext
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Phone Number*
-- ext

FINANCIAL INFORMATION

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Are there sources of funding other than revenues generated by the business itself?*
 

OWNERSHIP INFORMATION

ALL persons holding any interest in the business must be listed below including owners, officers, or directors. Please indicate the percentage of ownership (even if 0%) for each person. Total ownership must equal 100%. If there are more than 3 owners, please email the owner's information to liquor@davenportiowa.com.
OWNER 1
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Date of Birth*
 
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ZIP*
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Second portion of ZIP Code is optional.
Phone Number*
-- ext
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OWNER 2
 
 
 
Date of Birth 
 
 
 
 
ZIP 
-
Second portion of ZIP Code is optional.
Phone Number 
-- ext
 
 
 
OWNER 3
 
 
 
Date of Birth 
 
 
 
 
ZIP 
-
Second portion of ZIP Code is optional.
Phone Number 
-- ext
 
 
 
ADDITIONAL OWNERSHIP QUESTIONS
Has any person listed under "Ownership Information" for this license ever applied for a license to sell alcoholic beverages at any other location besides this application?*
 
Has any person listed under "Ownership Information" for this license ever been arrested or convicted of a felony?*
 
Has any person listed under "Owner Information" for this license ever been arrested or convicted of any alcohol, gambling, or moral charges?*
 

ELECTRONIC SIGNATURE

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By clicking "Submit", you are testifying that all information provided in this addendum is true and correct. False information could lead to a denial of the retail alcohol application.