Violator Submit Form - WA State Liquor Control Board

Thursday, July 2, 2009

If you wish to report any violation concerning a restaurant, tavern or grocery store, please complete the on-line form. Stars (**) next to an item indicate it is required for processing.

All "tips" will be received and investigated by a Liquor Control Board Enforcement Officer. For additional information on reporting liquor violations click here

Premises Category
Violation Type
Date Violation Occurred		Month: Day: Year:
Time Violation Occurred		*please use this format: 12:00 pm
** Premises Name
Address
** City
		Other City Name:
State		Washington
Phone Number

** Describe Alleged Violation

If you wish to be contacted by a Liquor Enforcement Agent, complete the following information.

Name		List any additional information that may be useful in contacting you.
	Release of name authorized
Title
Address
Telephone
FAX
E-mail

PRIVACY NOTICE INFORMATION