Delinquency/Cure List Form

Daily Cure List reports MUST BE SUBMITTED to the ILCC BY 3:00 P.M. to be reflected on the Daily Cure List Report. Please be advised that any Cure List Reports received after 3 p.m. will be posted on the next business day’s Cure List Report.

Delinquency List reports MUST BE SUBMITTED to the ILCC BY 3:00 P.M. THURSDAY for inclusion in that week’s Delinquency List. Please be advised that any Delinquency List Reports received after 3 p.m. Thursday will be posted with the next week’s Delinquency List (Thursday the following week).

Distributor Name

Distributor License Number

Retailer IL License Number

Please Enter all 10 positions, including the hyphen, as in the following example: 1A-0001234

Delinquent Corporation

Street Address

City

Date of Delinquency/Cure

Status

Delinquent

Cured

Note

Legal Agreement

I certify the above retailer has an outstanding debt for the purchase of wine or spirits which remains unpaid more than 30 days. Reporting a delinquency without a reasonable basis is a violation of the Act and could result in a license violation.

I certify the above referenced retailer has cured the previously reported delinquency. I acknowledge that removing the retailer from the delinquency list without a legal basis to do so is a violation of the Act and could result in a license violation.

You must certify to one of the following:

Attachments

Multiple files can be uploaded by holding down Shift or Ctrl while selecting.

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Chicago, IL 60602
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