Residential Solicitation Application Page 3
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42.
Master solicitor’s current contact information (including a telephone number and permanent and, if
applicable, local business address (not a post office box)):
Permanent address:
________________________________________________________
________________________________________________________
________________________________________________________
Telephone: _______________ Facsimile: __________________ E-Mail: _________________
Local address:
________________________________________________________
________________________________________________________
_________________________________________________________
Telephone: _______________ Facsimile: __________________ E-Mail: _________________
Please provide proof of the master solicitor’s tax exemption status, if applicable.
3.
Master solicitor’s social security number: ___ ___ ___-___ ___- ___ ___ ___ ___ or federal identification
4.
number ___ ___-___ ___ ___ ___ ___ ___.
5.
Please provide proof of possession of any license or permit which is required by the city in order to
conduct the proposed solicitation.
6.
Please check description of the nature of the business relationship of the solicitor to the master solicitor:
Employee
Agent
Independent contractor
Other, please explain: _________________________________________________.
’
P
D.
S
I
.
ART
OLICITOR
S
NFORMATION
Please provide the following information about the solicitor who will be conducting the actual solicitation.
Solicitor’s name (including any former names or aliases used during the last ten years):
1.
____________________________________________________________________________________
___________________________________________________________________________________.
Solicitor’s date of birth (month, day, year): ___-___-___ and social security number: ___ ___ ___-___
2.
___- ___ ___ ___ ___.
2.
Solicitor’s current contact information (including a telephone number and permanent and, if applicable,
local business address (not a post office box)):
Permanent address:
________________________________________________________
________________________________________________________
________________________________________________________
Telephone: _______________ Facsimile: __________________ E-Mail: _________________
Local address:
________________________________________________________
________________________________________________________
_________________________________________________________
Telephone: _______________ Facsimile: __________________ E-Mail: _________________
Please provide a copy of the solicitor’s valid state driver's license, a state-approved identification card
3.
with a photograph, or other form of government issued photo identification acceptable to the city clerk-
treasurer (The city clerk-treasurer will make a photocopy and attach to the application).
4.
If
a
vehicle
is
used
to
solicit,
please
provide
a
description
of
the
same:
_________________________________, together with the state where licensed: ____________, license
number:
______________________________,
and
the
vehicle
identification
number:
_____________________________.
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