SOLICITATION PERMIT

SOLICITATION PERMIT

Permit is valid for one (1) year from approval date. No soliciting is permitted before 9:00 am or after 7:00 pm or on Sundays unless a prior appointment has been made with the individual.
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
Date of Birth *

Month Day Year
Date
Upload copy of valid driver's license or state ID card. Must be able to see picture and read information. *

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Cancel of
Upload a valid copy of insurance card. Must show Insurance Company name, Insured Name, Vehicle Description and Policy Number. *

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Cancel of
Description of Merchandise or Nature of Services:
Is this a non-profit organization? (If yes, please attach proof of status)* *

Yes No
*Upload proof of non-profit status if applicable.

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Cancel of
Please add any additional comments you may have:
By Clicking Here, you acknowledge that all information provided is true and accurate.
Click HERE to make a payment (processing fee will be charged). Permit will not be approved without payment.
Approved by: Date: blank
Should be Empty: