Circular Non-Delivery Decal Order Form
Complete and submit this form to the Department of Licenses and Inspections if you do not want to receive hand delivered advertising circulars or handbills at your property.
Property Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Property Owner / Agent / Tenant's Name
*
First Name
Last Name
Property Owner / Agent / Tenant's Email
*
example@example.com
Property Owner / Agent / Tenant's Phone Number
*
Please enter a valid phone number.
A violation for leaving handbills / circulars at a property with a no-circulars sticker carries a $100 penalty. The address of the property must be included on the violation notice otherwise a violation cannot be processed. Please choose one:
*
I authorize the address provided above to appear on any violation notices issued for circulars / handbills left at my property.
I do not authorize my address to appear on violation notices. I understand this means that a violation for leaving circulars / handbills at my property cannot be issued.
Declaration
*
I hereby acknowledge that by signing this form, I no longer wish any unsolicited circulars / handbills, including sale circulars and coupons, to be left at my door. I further certify that the statements contained herein are true and correct to the best of my knowledge and belief.
Signature
*
Submit
Should be Empty: