Pennsylvania Liquor Control Board (PLCB) — Application Invoice

PLCB Payment Portal

Pennsylvania Liquor Control Board

Invoice # [[invoice_number]]

Issued: [[invoice_date]]

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2324 E 43rd St

Erie, Pennsylvania(PA), 16510

Pennsylvania(PA), 16510

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Commission Office

2327 New Hope St

Norristown, Pennsylvania(PA), 19401

Pennsylvania(PA), 19401

www.pa.gov/agencies/lcb

SKU Number

[[sku_number]]

Brand Name

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Container Size

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Date of Damage

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Invoice Total

[[refund_amount]]

Subtotal:

[[refund_amount]]

Pennsylvania State Tax (0%):

$0.00

TOTAL DUE

$ [[refund_amount]]

Payment Methods

Reference: [[invoice_number]]

Methods: Online portal, check, money order, or wire transfer