Application For Registration As A Camping Resort Salesperson Form - 2000
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1
2
3BUSINESS AND PROFESSIONS DIVISION
CAMPING RESORT SECTION
P .O. BOX 9649
OLYMPIA, WA 98507-9649
(360) 586-4575
APPLICATION FOR REGISTRATION AS A
FOR VALIDATION ONLY
CAMPING RESORT SALESPERSON
FEE: $100.00
Please make remittance payable to:
WASHINGTON STATE TREASURER
Click Here to Start, Then Tab From Field to Field
001-000-277-0008
! Original Application
! Renewal
! Transfer
Please type or print clearly in dark ink
Applicant Information
Please attach proof of identity (copy of current drivers license, birth certificate, Social Security card or
passport.)
(
)
Applicant Name
Residence Phone
LAST
FIRST
MIDDLE
AREA CODE
!
!
Date of Birth
Check one:
WA Resident
Non-resident
/
/
STATE
MONTH
DAY
YEAR
!
!
Place of Birth
Gender:
Male
Female
Social Security Number
(Required per RCW 26.23.150)
Previous registration date; name and license reference number:
Company Information
Business Name
Business Mailing Address
City
State
Zip
County
Physical Address of Business
IF DIFFERENT THAN ABOVE
City
State
Zip
County
(
)
Business Telephone Number
AREA CODE
For Office Use Only
Comments
Upon Filing, This Application Becomes A Public Record And Is
Subject To Public Disclosure Provisions Pursuant To RCW 42.17
The Department of Licensing has a policy of providing equal access to its services. If
you need special accommodation, please call (360) 586-4575 or TTY (360) 586-2788.
CC-612-017 CAMP RES. SLSPRSN. APP. (R/8/00)FM/W Page 1 of 3
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