Special Items Order Form

While the Division maintains a diverse selection of listed liquor products, occasionally customers request products not currently listed in Iowa. Such requests are referred to as special orders.

Special orders are non-listed products not stocked in the warehouse or listed in the Division price book for order on demand. As the Division cannot store products that are unique and infrequently requested, they can be obtained on an individual basis through the special order program.

The Division will contact suppliers regarding special order products for customers on an as needed basis.

If you are interested in a new product, you may Request a Quote using our online form.

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Alcohol Liquor Special Item Order Form

Form Instructions:

Enter your contact information. This area is required.
Enter products. At least one product is required.
For each product ordered, please complete all relevant fields.

Customer Information

Customer Number

Contact Name

Contact Phone

Contact Email

Product 1

Product 1 Name/Description

Product 1 Code

Product 1 Size

Product 1 Quantity (cases)

Product 2

Product 2 Name/Description

Product 2 Code

Product 2 Size

Product 2 Quantity (cases)

Product 3

Product 3 Name/Description

Product 3 Code

Product 3 Size

Product 3 Quantity (cases)

Product 4

Product 4 Name/Description

Product 4 Code

Product 4 Size

Product 4 Quantity (cases)

Product 5

Product 5 Name/Description

Product 5 Code

Product 5 Size

Product 5 Quantity (cases)

Receipt