Peddler's License Application
Applicant Information
| First Name |
michael
|
| Last Name |
reed
|
| 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 |
---
|
| Social Security # |
---
|
| Have you ever been convicted of any crime, misdemeanor or violation of any municipal ordinance other than traffic violations? |
---
|
Employment History
| Business Name, Address, Phone Number and Length of Employment: |
---
|
Business Name & Location
| Business/Company Name |
Good Ol
|
| Business Address |
3950 e. hwy 69
|
| Business Mailing Address |
3950 e. hwy 69
|
| Business Phone Number |
+19284451113
|
| Please provide a brief description of the nature of the business and the goods to be sold: |
---
|
| Please provide the source of supply of the goods or property proposed to be sold, or orders taken for the sale thereof; the location of the goods or products at the time this application is filed; and the proposed method of delivery: |
---
|
| Vehicle Information; Which car will you be driving? |
---
|
