Application shall be made at least ten (10)
days before the license is issued.APPLICATION FOR LICENSE FOR COMPANYDate:_____________ Name of Applicant:_____________________________________________________________________ Present Address:______________________________________________________________________ Previous Address:______________________________________________________________________ Owner: ________________________________________Business Phone:________________________ Federal ID No./Social Security No:________________________________________________________ Description of Vehicle to be used, if any: Year:_____________ Make:____________________________ Model:__________________ Color: _________________ License Number:________________________ Liability Insurance Company/Agent:________________________________________________________ _____________________________________________________________________________________ Other municipalities in which you have recently conducted activities and/or are licensed: _________________________________________ ________________________________________ _________________________________________ ________________________________________ Have you ever been arrested or convicted of any crime, misdemeanor or violation of any municipal ordinance? ___________ If so, state the nature of the offense and the punishment or penalty assessed thereof:_______________________________________________________________________________ _____________________________________________________________________________________ _______________________________________ Do not write below this line Investigated by: ________________________________ Date:__________________________________ 6 Months License $25.00 _____________ 12 Months License $50.00 _____________ Approved Denied _______________________________________ Date:__________________________ |