Town Of Prescott Valley Business License Division

Peddler's License

Aug 05, 2024
submission #180
Peddler's License Application

Applicant Information

First Name Joe
Last Name Hollom
Home Address (No PO Boxes) ---
Mailing Address ---
Phone Number ---
Date of Birth ---
Weight ---
Height ---
Sex ---
Hair Color ---
Eye Color ---
Driver's License # ---
DL State Issued ---
DL Expiration Date ---
Have you ever been convicted of any crime, misdemeanor or violation of any municipal ordinance other than traffic violations? ---